scholarly journals Myocardial damage in new coronavirus infection (review)

2021 ◽  
pp. 129-145
Author(s):  
Yu. V. Vakhnenko ◽  
A. V. Korotkikh ◽  
E. A. Bagdasaryan
Keyword(s):  
Acute Coronary Syndrome ◽  
Differential Diagnosis ◽  
Heart Diseases ◽  
Myocardial Damage ◽  
Diagnostic Methods ◽  
High Tech ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Coronavirus Infection ◽  
The Right

Introduction. Myocardial damage characteristic of novel coronavirus infection is a confirmed risk factor for its severe course and high mortality. There are biomarkers of this condition correlating with an unfavorable prognosis for the patient. However, the information on the problem of myocardial damage in the available literature is not fully systematic. It concerns pathogenesis, differential diagnosis of its causes, routing of patients with acute coronary syndrome. All the above is very important for choosing the right tactics of examination and treatment of patients, who are often limited in time. Aim. To summarize the data available at the time of writing from domestic and foreign researchers on the problem of myocardial damage and its main causes (acute coronary syndrome, myocarditis, stress cardiomyopathy) in COVID-19. Materials and methods. This review summarizes the data from articles published over the past two years found in PubMed, Google Scholar and eLIBRARY. Results. The authors tried to form a generalized modern understanding of the causes and structure of cardiovascular pathology and risk factors of its destabilization in patients infected with SARS-CoV-2, the markers of increased risk of COVID-infected heart and vascular diseases, the tactics of examination and treatment of this category of patients, routing individuals with acute coronary syndrome and its differential diagnosis with non-coronary heart diseases. The questions of organization and availability of the medical care in the conditions of the pandemic and social aspects of the world cardiology problems in the current situation have been studied. Conclusion. Patients with cardiovascular disease have a more severe prognosis of the severity and outcome of COVID-19, which is explained by its pathogenesis. The group at highest risk of lethal events is composed of individuals with signs of myocardial damage, the causes of which are the above mentioned conditions. Their differential diagnosis is a difficult clinical task, which requires a systematic analysis of the dynamics of clinical syndromes and data of additional diagnostic methods from routine to the most modern (high-tech) and, of course, deep knowledge of the present problem. The correct determination of the cause of myocardial damage and the choice of the right patient’s route through the treatment network determines the effectiveness of treatment and, therefore, the prognosis of the patient’s life. 

scholarly journals Pandemic of Fear or What Statistics Hide: Patients with Cardiovascular Disease are at Increased Risk During COVID-19

2021 ◽  
Vol 21 ◽  
Author(s):  
Oleg Gaisenok
Keyword(s):  
Cardiovascular Disease ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Diseases ◽  
Causes Of Death ◽  
Hospitalization Rate ◽  
Statistical Information ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
International Data ◽  
Coronavirus Infection

Insufficient statistical information on the structure of mortality in the era of the pandemic is disclosed in this article. It analyzes the statistics and the causes of death during the COVID-19 pandemic from a new coronavirus infection and cardiovascular disease. Actual international data on a decrease in the hospitalization rate of patients with acute coronary syndrome are presented. A comparative analysis of statistics from European countries and Russia shows that cardiovascular diseases are the leading cause of death in populations, and patients with cardiovascular diseases are at increased risk for morbidity and mortality during the COVID pandemic.

scholarly journals A Rare Case of Takotsubo Syndrome and Acute Coronary Syndrome of the Right Coronary Artery

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Nicholas Mencer ◽  
Larry Todd Justice ◽  
William Black ◽  
Kayleigh Litton
Keyword(s):  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Rare Case ◽  
Myocardial Damage ◽  
Takotsubo Syndrome ◽  
Benign Condition ◽  
Coronary Syndrome ◽  
The Right

Takotsubo syndrome (TTS) is an increasingly recognized heart disease that was initially regarded as a benign condition, but since has proven to cause irreversible myocardial damage, resembling that of acute coronary syndrome (ACS). The etiology of TTS is still uncertain but may be associated with catecholamine elevations during times of emotional or physical stress. Catecholamines are also understood to have prothrombotic properties, which could lead to ACS. With these similarities, differentiating these two pathologies can be difficult, especially when TTS and ACS occur simultaneously.

scholarly journals Profile of copper-associated DNA methylation and its association with incident acute coronary syndrome

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Pinpin Long ◽  
Qiuhong Wang ◽  
Yizhi Zhang ◽  
Xiaoyan Zhu ◽  
Kuai Yu ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Acute Coronary Syndrome ◽  
Methylation Level ◽  
Meta Analysis ◽  
Regulation Of Gene Expression ◽  
Density Lipoprotein ◽  
Blood Leukocytes ◽  
Coronary Syndrome ◽  
A Genome ◽  
Increased Risk

Abstract Background Acute coronary syndrome (ACS) is a cardiac emergency with high mortality. Exposure to high copper (Cu) concentration has been linked to ACS. However, whether DNA methylation contributes to the association between Cu and ACS is unclear. Methods We measured methylation level at > 485,000 cytosine-phosphoguanine sites (CpGs) of blood leukocytes using Human Methylation 450 Bead Chip and conducted a genome-wide meta-analysis of plasma Cu in a total of 1243 Chinese individuals. For plasma Cu-related CpGs, we evaluated their associations with the expression of nearby genes as well as major cardiovascular risk factors. Furthermore, we examined their longitudinal associations with incident ACS in the nested case-control study. Results We identified four novel Cu-associated CpGs (cg20995564, cg18608055, cg26470501 and cg05825244) within a 5% false discovery rate (FDR). DNA methylation level of cg18608055, cg26470501, and cg05825244 also showed significant correlations with expressions of SBNO2, BCL3, and EBF4 gene, respectively. Higher DNA methylation level at cg05825244 locus was associated with lower high-density lipoprotein cholesterol level and higher C-reactive protein level. Furthermore, we demonstrated that higher cg05825244 methylation level was associated with increased risk of ACS (odds ratio [OR], 1.23; 95% CI 1.02–1.48; P = 0.03). Conclusions We identified novel DNA methylation alterations associated with plasma Cu in Chinese populations and linked these loci to risk of ACS, providing new insights into the regulation of gene expression by Cu-related DNA methylation and suggesting a role for DNA methylation in the association between copper and ACS.

scholarly journals Circulating Levels of Dephosphorylated-Uncarboxylated Matrix Gla Protein in Patients with Acute Coronary Syndrome

Molecules ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 1108
Author(s):  
Admira Bilalic ◽  
Tina Ticinovic Kurir ◽  
Marko Kumric ◽  
Josip A. Borovac ◽  
Andrija Matetic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
High Risk ◽  
Hospital Mortality ◽  
Vascular Calcification ◽  
Matrix Gla Protein ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
St Elevation

Vascular calcification contributes to the pathogenesis of coronary artery disease while matrix Gla protein (MGP) was recently identified as a potent inhibitor of vascular calcification. MGP fractions, such as dephosphorylated-uncarboxylated MGP (dp-ucMGP), lack post-translational modifications and are less efficient in vascular calcification inhibition. We sought to compare dp-ucMGP levels between patients with acute coronary syndrome (ACS), stratified by ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) status. Physical examination and clinical data, along with plasma dp-ucMGP levels, were obtained from 90 consecutive ACS patients. We observed that levels of dp-ucMGP were significantly higher in patients with NSTEMI compared to STEMI patients (1063.4 ± 518.6 vs. 742.7 ± 166.6 pmol/L, p < 0.001). NSTEMI status and positive family history of cardiovascular diseases were only independent predictors of the highest tertile of dp-ucMGP levels. Among those with NSTEMI, patients at a high risk of in-hospital mortality (adjudicated by GRACE score) had significantly higher levels of dp-ucMGP compared to non-high-risk patients (1417.8 ± 956.8 vs. 984.6 ± 335.0 pmol/L, p = 0.030). Altogether, our findings suggest that higher dp-ucMGP levels likely reflect higher calcification burden in ACS patients and might aid in the identification of NSTEMI patients at increased risk of in-hospital mortality. Furthermore, observed dp-ucMGP levels might reflect differences in atherosclerotic plaque pathobiology between patients with STEMI and NSTEMI.

Letter in reply to the letter to the editor of Geerts N and Schanhorst V with the title “Roche Troponin T hs-STAT meets all expert opinion analytical laboratory practice recommendations for the use of the differential diagnosis of acute coronary syndrome”

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Anne Marie Dupuy ◽  
Anne Sophie Bargnoux ◽  
François Roubille ◽  
Jean Paul Cristol
Keyword(s):  
Acute Coronary Syndrome ◽  
Differential Diagnosis ◽  
Expert Opinion ◽  
Troponin T ◽  
Analytical Laboratory ◽  
Laboratory Practice ◽  
Coronary Syndrome ◽  
Practice Recommendations ◽  
Letter To The Editor

AbstractOver the period from December 3rd, 2019 to March 13th, 2020, after the urgent field safety notice reported by Roche, we performed double determinations of all troponins from the same tube in parallel and in the same run. We used the same Elecsys troponin T hs reagent (ref 08469873190), first result was obtained with the current hs-cTnT application (18 min) and the second measurement was with the STAT application (9 min). On the 11,388 results in the range from 3 to 500 ng/L, we observed 4.18% discordant results (above 18.8% RCV). Overall, we observed an overestimation of the hs-cTnT STAT assay. The Elecsys Troponin T hs STAT assay demonstrated good analytical performances on Cobas e801 analyzer. However, its use according to the ESC recommendations for the 0 h/1 h algorithm should be carefully evaluated and requires further studies with serial cTn testing.

Candidate Genes of the 5-Lipoxygenase Pathway in Acute Coronary Syndrome: A Pilot Study

2008 ◽  
Vol 9 (4) ◽  
pp. 280-292 ◽  
Author(s):  
Shu-Fen Wung ◽  
Bradley E. Aouizerat
Keyword(s):  
Acute Coronary Syndrome ◽  
Pilot Study ◽  
Nucleotide Polymorphisms ◽  
Common Allele ◽  
Lipoxygenase Pathway ◽  
Single Nucleotide ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Caucasian Patients ◽  
Alox5ap Gene

Purpose. The purpose of this pilot study was to examine arachidonate 5-lipoxygenase (ALOX5) and ALOX5-activating protein (ALOX5AP) gene variations in patients with and without acute coronary syndrome (ACS). Methodology. Four and six single nucleotide polymorphisms spanning the ALOX5 and ALOX5AP genes, respectively, were genotyped in 19 non-Hispanic Caucasian patients with ACS and 27 controls. Results. Presence of the common allele of rs9508835 (ALOX5AP) and the minor allele of rs2029253 (ALOX5) were associated with ACS. After adjustment for age, being a carrier of the rs9508835 common allele was associated with an increased risk of ACS (odds ratio = 2.86). Relevance for nursing practice. Through the inhibition of the ALOX5AP gene by downregulation of the leukotriene pathway, the risk of ACS may be decreased in individuals that carry susceptibility allele(s). Knowledge of the genetic basis of treatments that downregulate the leukotriene pathway may prove essential to the care of individuals with ACS.

Abstract 12644: Growth Differentiation Factor-15 (GDF-15) for Risk Stratification in Patients After an Acute Coronary Syndrome: Insights From the SOLID-TIMI 52 trial

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Eri Toda Kato ◽  
David A Morrow ◽  
Christopher P Cannon ◽  
Mary Ann Lukas ◽  
Andrzej Budaj ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Biomarkers ◽  
Individual Element ◽  
Clinical Predictors ◽  
Coronary Syndrome ◽  
Differentiation Factor ◽  
Increased Risk ◽  
Prognostic Utility ◽  
Traditional Risk Factors ◽  
Risk Predictors

Background: Growth differentiation factor (GDF)-15, a stress responsive cytokine, is associated with the risk of CV events after an acute coronary syndrome (ACS). Unlike other established cardiac biomarkers, the level of GDF-15 remains elevated in sub-acute phase after ACS and gradually decreases over time. We evaluated the prognostic utility of GDF-15 in patients after ACS accounting for established markers and risk predictors. Methods: GDF-15 (R&D Systems) and other established cardiac biomarkers (BNP, hsCRP and hsTnI) were measured at baseline in a randomly selected cohort of 4,968 patients enrolled within 30 days of hospitalization with ACS (median=14d) in SOLID-TIMI 52. Previously defined cutpoints were applied for GDF-15 concentration: <1200 (n=3451), 1200-1800 (n=919), and > 1800 ng/L (n=598). Analyses were adjusted for established risk predictors, days from the ACS event and other markers. MACE was defined as CV death, MI or stroke. Median follow-up was 2.5 years. Results: Patients with higher GDF-15 tended to be older, more likely to have diabetes, hypertension, history of revascularization, and CKD at baseline. Higher baseline levels of GDF-15 identified patients with higher rates of MACE as well as each individual element (p-trend <0.001 for all endpoints, Fig). The rate of MI was ∼2-fold higher in those with GDF-15 concentration >1800ng/L compared to patients with GDF-15 concentration <1200 ng/L. After adjustment for clinical predictors and other markers, GDF-15 was independently associated with the risk of MACE (HR 1.4, 95% CI 1.1-1.7; HR 1.8, 95% CI 1.4-2.3 for GDF-15 1200-1800, >1800, respectively). Individuals with GDF-15 >1800 ng/L had an increased risk of MI (adj HR 1.4, 95% CI 1.1-2.0) and stroke (adj HR 2.3, 95% CI 1.3-3.9). Conclusion: In patients after ACS, GDF-15 concentration is associated with the risk of MACE including MI and stroke independent of traditional risk factors and risk markers.

Redefining residual inflammatory risk after acute coronary syndrome

2021 ◽  
Author(s):  
Marco G Del Buono ◽  
Rocco A Montone ◽  
Giulia Iannaccone ◽  
Riccardo Rinaldi ◽  
Giulia La Vecchia ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Multimodality Imaging ◽  
Short Review ◽  
Local Inflammation ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Atherosclerotic Plaque Formation ◽  
Long Term Follow Up ◽  
Coronary Syndromes

Over the last decades, inflammation proved to play a pivotal role in atherosclerotic plaque formation, progression and destabilization. Several studies showed that the patients presenting with acute coronary syndrome are at increased risk of adverse cardiovascular events at both short- and long-term follow-up. Results from different clinical trials highlighted that a residual inflammatory risk exist and targeting inflammation is a successful strategy in selected cases associated to an increased inflammatory burden. Recently, the optimization of intracoronary and multimodality imaging allowed to also assess the entity of local inflammation, thus encouraging the individuation of plaque characteristics that portend a higher risk of future cardiovascular events. In this short review, we aim to highlight the role of systemic and local inflammation in acute coronary syndromes, to provide a summarized overview of the possible medical strategies applicable in selected cases and to underline the diagnostic and prognostic potential of multimodality imaging.

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