The Plasma Level of N-terminal Pro B-type Natriuretic Peptide(NT-proBNP) for Severity of Coronary Artery Stenosis and Early Risk Stratification in Patients with Non ST Elevation Acute Coronary Syndrome

Acute Coronary syndrome (ACS) is the most common cause of admission to the coronary care unit with highest risk of death and adverse outcomes. ACS accounts for 6070% of all admissions in the hospital. Patients with ACS encompass a heterogeneous group that varies widely regarding severity of the underlying coronary artery disease, prognosis and response to treatment. Patients with the highest risk of subsequent events usually have the largest benefit of an intensified pharmacological treatment and early mechanical intervention. The prognosis for low-risk patients, on the other hand, is often difficult to improve further and these patients usually benefit more from a conservative management with a lower risk of side effects. Therefore, risk stratification is essential and should be initiated early and updated continuously throughout the hospital stay. Early risk stratification is usually performed by the use of clinical background factors, clinical presentation, electrocardiography and biochemical markers of myocardial damage. Levels of natriuretic peptides have been shown to reflect cardiac performance. The aim of this study was to review elaborately on B type Natriuretic Peptide (BNP) and its prognostic value in patient with ACS. This review focuses on the emerging role of these peptides in the early risk stratification of ACS patients. Elevation of BNP levels in acute MI and UA is predictive of a greater risk of death, post infarction heart failure, or reinfarction. Post infarction studies demonstrate that elevated plasma BNP levels are associated with larger infarct size, increased probability of ventricular remodeling, lower ejection fraction, higher risk of heart failure, and increased mortality. This cardiac marker is a potent predictor of mortality in patients with all forms ACS. BNP measurements serve as an index of severity of the ischemic injury, as well as the degree of impairment in left ventricular function.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21079

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Serum exosomal miR-122-5p is a new biomarker for both acute coronary syndrome and underlying coronary artery stenosis

Biomarkers ◽

10.1080/1354750x.2020.1803963 ◽

2020 ◽

Vol 25 (7) ◽

pp. 539-547

Author(s):

Hao Ling ◽

Ziyuan Guo ◽

Shuangshuang Du ◽

Yinghong Liao ◽

Yunyan Li ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Coronary Syndrome

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Lesion characteristics and prognosis of acute coronary syndrome without angiographically significant coronary artery stenosis

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez079 ◽

2019 ◽

Cited By ~ 2

Author(s):

Akira Taruya ◽

Atsushi Tanaka ◽

Tsuyoshi Nishiguchi ◽

Yuichi Ozaki ◽

Manabu Kashiwagi ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Significant Coronary Artery Stenosis ◽

Coronary Syndrome

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IP-0052 Serun neopterin predicts severity of coronary artery stenosis and prognosis in acute coronary syndrome

Atherosclerosis Supplements ◽

10.1016/s1567-5688(03)90127-9 ◽

2003 ◽

Vol 4 (2) ◽

pp. 30-31

Author(s):

S. Chae ◽

D. Yang ◽

H. Park ◽

Y. Cho ◽

J. Jun ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Coronary Syndrome

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Hyperhomocysteinemia and Acute Coronary Syndrome: A Hospital-Based Observational Study Among Very Young Adults ≤35 Years of Age

10.21203/rs.3.rs-116489/v1 ◽

2020 ◽

Author(s):

Jiayin Sun ◽

Wei Han ◽

Sijing Wu ◽

Shuo Jia ◽

Zhenxian Yan ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Young Adults ◽

Coronary Artery ◽

Coronary Artery Stenosis ◽

Young Patients ◽

Left Ventricular ◽

Artery Stenosis ◽

Left Ventricular Ejection ◽

Gensini Score ◽

Coronary Syndrome

Abstract Background: The prevalence of acute coronary syndrome (ACS) continues to increase among young Chinese adults. Homocysteine (HCY) has been suggested as a crucial promoter of atherosclerosis leading to coronary artery disease (CAD). Yet, it remains uncertain whether HCY is associated with the ACS and the severity of coronary artery stenosis in very young adults.Methods: Very young patients (18-35years of age) diagnosed with ACS who underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and June 2019 were assigned to the ACS group. An equivalent age-matched population without CAD, as confirmed by CAG during the same period, was assigned to the non-CAD group. A serum HCY level>15µmol/L was defined as hyperhomocysteinemia (HHCY). The Gensini score assessed the severity of coronary artery stenosis.Results: A total of 1,103 participants, including 828 ACS patients and 275 non-CAD subjects, were included in this study. Very young ACS patients had higher level of serum HCY and greater prevalence of HHCY compared with non-CAD subjects [for HCY, 16.55 (11.93- 29.68) vs 12.50 (9.71- 17.42), P<0.001; for HHCY prevalence, 62.08% vs 26.18%, P<0.001]. Multivariate logistic regression analysis with the stepwise method indicated that HHCY was an independent predictor associated with the presence of ACS, after adjusting for traditional confounders (OR, 4.393; 95% CI, 3.171-6.087; P<0.001). Moreover, young ACS patients with HHCY had increased prevalence of ST-segment elevation myocardial infarction (STEMI) (P=0.041), multi-vessel disease (P=0.036), and decreased value of left ventricular ejection fraction (LVEF) (P=0.01). Also, the HCY level was signiﬁcantly correlated with Gensini Score in ACS patients (r=0.142, P<0.001).Conclusion: HHCY was significantly associated with the presence of ACS and the severity of coronary artery stenosis in very young patients ≤35 years of age.

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Associations of Circulating microRNA-221 and 222 With the Severity of Coronary Artery Lesions in Acute Coronary Syndrome Patients

Angiology ◽

10.1177/00033197211034286 ◽

2021 ◽

pp. 000331972110342

Author(s):

Xin Yu ◽

Jian-feng Xu ◽

Ming Song ◽

Lei Zhang ◽

Yi-hui Li ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Coronary Artery Stenosis ◽

Quantitative Polymerase Chain Reaction ◽

Area Under The Curve ◽

Artery Stenosis ◽

Circulating Microrna ◽

Coronary Artery Lesions ◽

Expression Levels ◽

Coronary Syndrome

Circulating levels of microRNA-221 and 222 (miR-221/222) in patients with coronary artery disease (CAD) are elevated, yet the relationship between circulating miR-221/222 and the severity of coronary lesions in patients with acute coronary syndrome (ACS) remains unknown. In this study, the relative expression levels of circulating miR-221/222 in patients with ACS (n = 267) and controls (n = 71) were compared by real-time fluorescence quantitative-polymerase chain reaction (RT-qPCR). The ACS group was further divided into unstable angina pectoris (UA) group (n = 191) and acute myocardial infarction (AMI) group (n = 76). Significant upregulation of circulating miR-221/222 was observed in ACS. A positive linear correlation between circulating miR-221/222 and Gensini scores was demonstrated. The area under the curve (AUC) of circulating miR-221/222 in the diagnosis of coronary artery stenosis ≥50% was 0.605 and 0.643, respectively. The circulating miRNA-221/222 expression levels in ACS patients were elevated and positively associated with the severity of the coronary artery lesions. Circulating miR-221/222 may be novel biomarkers for the diagnosis of coronary artery stenosis ≥50% and the occurrence of ACS.

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