scholarly journals Prognostic Value of Cortisol Index of Endobiogeny in Acute Myocardial Infarction Patients

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 602
Author(s):  
Rima Braukyliene ◽  
Kamyar Hedayat ◽  
Laura Zajanckauskiene ◽  
Martynas Jurenas ◽  
Ramunas Unikas ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Prognostic Value ◽  
Troponin I ◽  
Complete Blood Count ◽  
Serum Cortisol ◽  
Mean Values ◽  
Risk Of Mortality ◽  
Poor Outcomes ◽  
Diagnostic Coronary Angiography

Background and Objectives: Serum cortisol has been extensively studied for its role during acute myocardial infarction (AMI). Reports have been inconsistent, with high and low serum cortisol associated with various clinical outcomes. Several publications claim to have developed methods to evaluate cortisol activity by using elements of complete blood count with its differential. This study aims to compare the prognostic value of the cortisol index of Endobiogeny with serum cortisol in AMI patients, and to identify if the risk of mortality in AMI patients can be more precisely assessed by using both troponin I and cortisol index than troponin I alone. Materials and methods: This prospective study included 123 consecutive patients diagnosed with AMI. Diagnostic coronary angiography and revascularization was performed for all patients. Cortisol index was measured on admission, on discharge, and after 6 months. Two year follow-up for all patients was obtained. Results: Our study shows cortisol index peaks at 7–12 h after the onset of AMI, while serum cortisol peaked within 3 h from the onset of AMI. The cortisol index is elevated at admission, then significantly decreases at discharge; furthermore, the decline to its bottom most at 6 months is observed with mean values being constantly elevated. The cortisol index on admission correlated with 24-month mortality. We established combined cut-off values of cortisol index on admission > 100 and troponin I > 1.56 μg/las a prognosticator of poor outcomes for the 24-month period. Conclusions: The cortisol index derived from the global living systems theory of Endobiogeny is more predictive of mortality than serum cortisol. Moreover, a combined assessment of cortisol index and Troponin I during AMI offers more accurate risk stratification of mortality risk than troponin alone.

scholarly journals THE DYNAMICS OF NEUROHUMORAL MEDIATORS OF VASOCONSTRICTION AND VASODILATION AND TROPONIN I IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION DEPENDING ON THE DEGREE OF CONCOMITANT OBESITY

2020 ◽  
Vol 73 (9) ◽  
pp. 1940-1943
Author(s):  
Nataliya G. Ryndina ◽  
Pavlo G. Kravchun ◽  
Olexandra S. Yermak ◽  
Kateryna M. Borovyk ◽  
Ganna Yu. Tytova ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Enzyme Immunoassay ◽  
High Activity ◽  
Troponin I ◽  
Comparison Group ◽  
Age And Gender ◽  
Mean Values ◽  
The Mean ◽  
And Gender

The aim: Is to evaluate copetin’s, MRproADM’s and troponin’s I dynamic in patients with acute myocardial infarction depending on the degree of concomitant obesity. Material and methods: The study included 105 patients with AMI. There were formed 2 groups: 1st group of patients with AMI and concomitant obesity (n=75), 2nd group – patients with AMI without obesity (n=30). 37 patients had obesity of the I degree, 38 patients - II degree. The groups were comparable in age and gender. Copeptin, MRproADM, troponin I were determined by enzyme immunoassay method. Data are presented as mean values and the error of the mean (M±m). Differences were considered statistically significant at p<0,05. Results: It was found an increased copeptin’s level by 73,8 % (p<0,001) in obesity I degree and by 205,9 % in obesity II degree compared with group with isolated AMI, MRproADM - by 30,68 % (p<0,001) and 54,5 % (p<0,001) respectively. Concentration of copeptin was higher by 76 % (p<0,001) in patients with AMI and II degree obesity comparing to patients with obesity of I degree, and MRproADM - by 18,3% (p<0,001) respectively. Troponin I value fully corresponded the comparison group both in obesity of I degree and II degree (p>0,05). Conclusions: The present study provides evidence that a high activity of copeptin and MRproADM in patients with AMI and obesity of I degree with an excessive activity of a marker of vasoconstriction copeptin in conditions of moderate inadequate to the needs MRproADM functioning in patients with obesity of II degree.

scholarly journals Onset time and prognostic value of acute kidney injury in patients with acute myocardial infarction

2021 ◽  
Vol 35 ◽  
pp. 100826
Author(s):  
Ryota Kosaki ◽  
Kohei Wakabayashi ◽  
Shunya Sato ◽  
Hideaki Tanaka ◽  
Kunihiro Ogura ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Prognostic Value ◽  
Onset Time ◽  
Kidney Injury

scholarly journals Long-Term Prognostic Value of Cognitive Impairment on Top of Frailty in Older Adults after Acute Coronary Syndrome

2021 ◽  
Vol 10 (3) ◽  
pp. 444
Author(s):  
Juan Sanchis ◽  
Clara Bonanad ◽  
Sergio García-Blas ◽  
Vicent Ruiz ◽  
Agustín Fernández-Cisnal ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Older Adults ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Prognostic Value ◽  
Adult Survivors ◽  
Prognostic Information ◽  
Coronary Syndrome

Frailty is a marker of poor prognosis in older adults after acute coronary syndrome. We investigated whether cognitive impairment provides additional prognostic information. The study population consisted of a prospective cohort of 342 older (>65 years) adult survivors after acute coronary syndrome. Frailty (Fried score) and cognitive function (Pfeiffer’s Short Portable Mental Status Questionnaire—SPMSQ) were assessed at discharge. The endpoints were mortality or acute myocardial infarction at 8.7-year median follow-up. Patient distribution according to SPMSQ results was: no cognitive impairment (SPMSQ = 0 errors; n = 248, 73%), mild impairment (SPMSQ = 1–2 errors; n = 52, 15%), and moderate to severe impairment (SPMSQ ≥3 errors; n = 42, 12%). A total of 245 (72%) patients died or had an acute myocardial infarction, and 216 (63%) patients died. After adjustment for clinical data, comorbidities, and Fried score, the SPMSQ added prognostic value for death or myocardial infarction (per number of errors; HR = 1.11, 95%, CI 1.04–1.19, p = 0.002) and death (HR = 1.11, 95% 1.03–1.20, p = 0.007). An SPMSQ with ≥3 errors identified the highest risk subgroup. Geriatric conditions (SPSMQ and Fried score) explained 19% and 43% of the overall chi-square of the models for predicting death or myocardial infarction and death, respectively. Geriatric assessment after acute coronary syndrome should include both frailty and cognitive function. This is particularly important given that cognitive impairment without dementia can be subclinical and thus remain undetected.

scholarly journals Prognostic Value of QRS Fragmentation in Patients with Acute Myocardial Infarction: A Meta-Analysis

2016 ◽  
Vol 21 (6) ◽  
pp. 604-612 ◽  
Author(s):  
Barış Güngör ◽  
Kazım Serhan Özcan ◽  
Mehmet Baran Karataş ◽  
İrfan Şahin ◽  
Recep Öztürk ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Qrs Fragmentation

Alterations in serum selenium levels and their relation to troponin I in acute myocardial infarction

2010 ◽  
Vol 345 (1-2) ◽  
pp. 23-27 ◽  
Author(s):  
Barbara Kutil ◽  
Petr Ostadal ◽  
Jiri Vejvoda ◽  
Jiri Kukacka ◽  
Jana Cepova ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Troponin I ◽  
Serum Selenium ◽  
Serum Selenium Levels

Abstract P73: Comparison of Hospital-Acquired Anemia and TIMI Bleeding for Mortality Prediction in Patients with Acute Myocardial Infarction

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Adam C Salisbury ◽  
Amit P Amin ◽  
Karen P Alexander ◽  
Frederick A Masoudi ◽  
Yan Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
At Risk ◽  
Assessment Tool ◽  
Mortality Prediction ◽  
Logistic Regression Models ◽  
Net Reclassification Improvement ◽  
Risk Patients ◽  
Poor Outcomes ◽  
Hospital Acquired

Background: In-hospital bleeding and new onset, hospital acquired anemia (HAA) are both associated with higher mortality in acute myocardial infarction (AMI). Since bleeding is variably defined and often poorly documented, HAA could be a better method to identify at-risk patients, if its prognostic ability were at least as good as documented bleeding. We directly compared the association of HAA and TIMI bleeding with 1-year mortality. Methods: Among 2,803 AMI patients who were not anemic at admission in the 24-center TRIUMPH registry, the presence and severity of HAA and TIMI bleeding were prospectively collected to identify their relative discrimination of 1-year mortality. Logistic regression models, accounting for clustering using generalized estimating equations, were fit for 1) no bleeding, TIMI minimal, minor and major bleeding and 2) no HAA, mild (hemoglobin (Hgb) > 11 g/dl), moderate (Hgb 9 - 11 g/dl) and severe HAA (Hgb < 9 g/dl). Discrimination was compared using c-statistics and reclassification was assessed using the integrated discrimination improvement (IDI), which measures a model's improvement in average sensitivity without sacrificing average specificity vs. another model, and the continuous net reclassification improvement (NRI), to identify the proportion of patients correctly reclassified by the HAA model. Results: HAA was more common (mild: 33%, moderate: 10%, severe 2%) than TIMI bleeding (minimal: 5%, minor: 3%, major 1%). Over 1-year follow-up, 111 patients (4%) died. The HAA model was superior to TIMI bleeding model for 1-year mortality prediction (c-statistic 0.60 vs. 0.51, p<0.001). The IDI of the HAA vs. the bleeding model was 0.009 (95% CI 0.005 - 0.014) and the relative IDI was 0.26 (26% better average discrimination), with a NRI of 0.32 (0.13-0.50) - 17% of patients with events were correctly reclassified to a higher risk while 14% of patients without events were correctly reclassified to a lower risk by the HAA model. Conclusions: HAA is better than TIMI bleeding for identifying 1-year mortality after AMI hospitalization, and may better identify patients without recognized bleeding who are also at risk for poor outcomes. HAA may be useful to identify high-risk patients and as a quality assessment tool.

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