scholarly journals Distribution of allelic variants of genes inhibitors and activators ectopic calcification in patients with acute coronary syndrome

1970 ◽  
Vol 21 ◽  
pp. 306-310
Author(s):  
V. Yu. Harbuzova ◽  
O. A. Obukhova ◽  
I. O. Rozumenko ◽  
Ye. I. Dubovyk ◽  
T. M. Oleshko ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Venous Blood ◽  
Control Group ◽  
Ectopic Calcification ◽  
Allelic Polymorphism ◽  
Coronary Syndrome ◽  
Major Allele ◽  
Polymorphic Variants ◽  
Sclerotic Lesions ◽  
Hereditary Susceptibility

Aim. The study of the distribution of polymorphic variants K121Q (gene ENPP1), T134967G (gene ANKH) and A69314G (gene TNAP) is in patients with acute coronary syndrome. Methods. Venous blood of 118 patients with ACS and 110 persons of control group were genotyped for the polymorphism by PCR and restriction fragment length polymorphism method. Results. There is an association between acute coronary syndrome and polymorphic variants of genes TNAP (A69314G) and ANKH (T134967G). ACS risk in carriers of the minor allele of A69314G polymorphism to 2.2 times (P = 0.013; OR = 2.244), and for T134967G polymorphism to 1.9 times (P = 0.024; OR = 1.857) higher than homozygotes for the major allele. Conclusions. Allelic polymorphism gene activators and inhibitors of ectopic calcification is an important factor in hereditary susceptibility to sclerotic lesions of arteries and their complications. Keywords: gene polymorphism, calcification, acute coronary syndrome.

Prevalence of Vitamin-D Deficiency in Patients with Acute Coronary Syndrome in Syria

2016 ◽  
Vol 9 (6) ◽  
pp. 3544-3548
Author(s):  
Aya Hallak ◽  
Malhis Mahmoud ◽  
Yaser Abajy Mohammad
Keyword(s):  
Vitamin D ◽  
Acute Coronary Syndrome ◽  
Vitamin D Deficiency ◽  
Hypovitaminosis D ◽  
Control Group ◽  
Coronary Syndrome ◽  
Normal Individuals ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Coronary Syndromes

The objectives of this study were to estimate the prevalence of vitamin D deficiency in patients with acute coronary syndrome in comparison with normal individuals and study the correlation between these two conditions. We measured the plasma 25-hydroxy vitamin D (25-OH-D) levels in 60 patients with acute coronary syndromes (ACS) of both gender and in 30 age matched control individuals of both gender without any known cardiovascular or systemic diseases. The levels of 25-OH-D were measured by ELISA method and the results were statically analyzed to find out any possible correlation. We classified the cases according to their plasma 25(OH)D levels. 25(OH)D levels of ≥ 30 ng/ml were considered normal, levels < 30 and > 20 ng/ml were classified as insufficient, while levels of ≤ 20 ng/ml were classified as deficient. In the current study the prevalence of hypovitaminosis D in the patients group was much higher than it was in the control group. Vitamin D deficiency was observed in 80% and insufficiency in 13% of total patients of ACS, there by bringing the total count to 93%. Whereas only 7% of the patients had adequate vitamin D levels. Thus, these results indicate the existence of a significant correlation between the vitamin D deficiency and ACS in comparison to healthy controls

scholarly journals Acute Myocardial Infarction In Systemic Mastocytosis: Case Report With Literature Review Of The Role Of Inflammatory Process In Acute Coronary Syndrome

2020 ◽  
Vol 16 ◽  
Author(s):  
Ayman Battisha ◽  
Khalid Sawalha ◽  
Bader Madoukh ◽  
Omar Sheikh ◽  
Karim Doughem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Plasma Lipids ◽  
Plaque Rupture ◽  
Systemic Mastocytosis ◽  
Cardiac Risk ◽  
Control Group ◽  
Coronary Syndrome

: Systemic Mastocytosis (SM) is a disorder of excessive mast cell infiltration in multiple organ tissues. Atherosclerosis is a major risk factor for developing acute coronary syndrome [1]. In addition to lipid accumulation in the arterial wall, inflammation plays an important role in the pathogenesis of plaque rupture and activating the thrombosis cascade [2]. The Mast cells contribution to plaque destabilization has been well established in multiple animal and human studies [3]. In a recent study, SM has been proven to be associated with a higher incidence of acute coronary syndrome even with lower plasma lipids level [4]. The study showed that 20% of patients with SM had cardiovascular events compared to only 6% in the control group with adjustment to all cardiac risk factors. Here, we present a case of acute myocardial infarction in a patient with SM with limited risk factors other than age.

A STUDY OF HYPERURICACIDEMIA AND THE PRESENCE AND SEVERITY OF ACUTE CORONARY SYNDROME IN INDEX MEDICAL COLLEGE, HOSPITAL AND RESEARCH CENTER, INDORE ( M.P.)

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
B. Khanam ◽  
M. Imran Khan ◽  
Ajay Kumar Singh ◽  
Sumit Solanki ◽  
S.M. Holkar
Keyword(s):  
Acute Coronary Syndrome ◽  
Control Group ◽  
Case Group ◽  
College Hospital ◽  
Medical College ◽  
Coronary Syndrome ◽  
Luminal Stenosis ◽  
Angiographic Evidence ◽  
The Mean ◽  
High Uric Acid

Background: Few studies have assessed the relation of hyperuricacidemia with the acute coronary syndrome (ACS). This study investigated the association between high uric acid levels with the presence and severity of ACS.  Methods: Three hundred and seventy patients having angiographic evidence of atherosclerosis (CAD + case group) compared to 170 patients with no luminal stenosis (n=110) or with <50% luminal stenosis (n=60) at coronary angiography (CAD – control group). Results: The mean age of the patients was 60 ± 10 years (317 men, 58.7%). Hyperuricacidemia was more likely associated with a trend toward higher vessel scores, indicating a more severe CAD (adjusted OR=1.51, 95% CI=1.09-2.09; P=0.005) in the whole population. A comparison of sex-specific values showed a significant association existed only in men. Conclusions: Asymptomatic hyperuricacidemia may be associated with the presence and severity of ACS. Keywords: Hyperuricacidemia, Severity & Acute Coronary Syndrome.

Genotype-Phenotype Association and Impact on Outcomes following Guided De-Escalation of Anti-Platelet Treatment in Acute Coronary Syndrome Patients: The TROPICAL-ACS Genotyping Substudy

2018 ◽  
Vol 118 (09) ◽  
pp. 1656-1667 ◽  
Author(s):  
Lisa Gross ◽  
Dietmar Trenk ◽  
Claudius Jacobshagen ◽  
Anne Krieg ◽  
Meinrad Gawaz ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Platelet Reactivity ◽  
Bleeding Risk ◽  
Coronary Intervention ◽  
Control Group ◽  
Carrier Status ◽  
Unique Identifier ◽  
Clinical Trial Registration ◽  
Coronary Syndrome ◽  
Alternative Treatment Strategy

Background Phenotype-guided de-escalation (PGDE) of P2Y12-inhibitor treatment with an early switch from prasugrel to clopidogrel was identified as an effective alternative treatment strategy in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The Testing Responsiveness to Platelet Inhibition on Chronic Antiplatelet Treatment for Acute Coronary Syndromes (TROPICAL-ACS) Genotyping Substudy aimed to investigate whether CYP2C19 genotypes correlate with on-treatment platelet reactivity (PR) in ACS patients treated with clopidogrel or prasugrel and thus might be useful for guidance of early de-escalation of anti-platelet treatment. Methods and Results A total of 603 ACS consecutive patients were enrolled in four centres (23.1% of the overall TROPICAL-ACS population). Rapid genotyping (Spartan RX) for CYP2C19*2, *3 and *17 alleles was performed. Associations between PR and the primary and secondary endpoints of the TROPICAL-ACS trial and CYP2C19*2 and CYP2C19*17 carrier status were evaluated.For the PGDE group, the on-clopidogrel PR significantly differed across CYP2C19*2 (p < 0.001) and CYP2C19*17 genotypes (p = 0.05). Control group patients were not related (p = 0.90, p = 0.74) to on-prasugrel PR. For high PR versus non-high PR patients within the PGDE group, significant differences were observed for the rate of CYP2C19*2 allele carriers (43% vs. 28%, p = 0.007). Conclusion CYP2C19*2 and CYP2C19*17 carrier status correlates with PR in ACS patients treated with clopidogrel and thus might be useful for pre-selecting patients who will and who may not be suitable for PGDE of anti-platelet treatment. Regarding phenotype-guided treatment, we did not observe added benefit of genotyping to predict ischaemic and bleeding risk in patients who underwent a PGDE approach. Clinical Trial Registration URL: https//www.clinicaltrials.gov. Unique Identifier: NCT: 01959451.

scholarly journals Analysis of ticagrelor’s cardio-protective effects on patients with ST-segment elevation acute coronary syndrome accompanied with diabetes

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 234-240 ◽  
Author(s):  
Dong-Tao Li ◽  
Shun-Bao Li ◽  
Jian-Yong Zheng ◽  
Hai-hong Tang ◽  
Yi-Gang Qiu ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Adverse Reactions ◽  
Left Ventricular ◽  
Control Group ◽  
Observation Group ◽  
Protective Effects ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome

AbstractBackgroundTo analyze the cardio-protective effects of ticagrelor in patients with acute coronary syndrome with S-T segment elevation.MethodsThe sample was 200 patients who had been diagnosed with acute coronary syndrome accompanied by diabetes Mellitus type II. Only patients having ST segment elevation before the treatment were included. Then, the subjects were further randomly divided into an observation group and a control group. The control group of 100 patients received clopidogrel; the observation group of 100 patients of ticagrelor. The serous creatine kinase CK-MB, functional cardiac indexes of left ventricular end diastolic diameter (LVDD), cardiac troponin I, ventricular ejection fraction, and relevant major adverse cardiovascular events (MACE) were compared between the two groups.ResultsOne month after a percutaneous coronary intervention (PCI) the observation group showed better results against angina, stent thrombosis, and all-cause mortality compared with those of the control subjects. Six months after treatment, both groups suffered adverse reactions. The number of patients who suffered adverse reactions in respiratory tract in the observation group was higher than in the control group. The inhibition of platelet aggregation IPA of ticagrelor was found to be significantly higher than clopidogrel, having a significant p value.ConclusionTicagrelor can effectively protect myocardial function for patients with ST-segment elevation acute coronary syndrome accompanied by diabetes and can reduce the incidence of adverse reactions..

Platelet reactivity and clinical outcomes in acute coronary syndrome patients treated with prasugrel and clopidogrel: a pre-specified exploratory analysis from the TROPICAL-ACS trial

2019 ◽  
Vol 40 (24) ◽  
pp. 1942-1951 ◽  
Author(s):  
Dániel Aradi ◽  
Lisa Gross ◽  
Dietmar Trenk ◽  
Tobias Geisler ◽  
Béla Merkely ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Clinical Outcomes ◽  
Independent Predictor ◽  
Platelet Reactivity ◽  
Academic Research ◽  
Study Groups ◽  
Cardiovascular Death ◽  
Control Group ◽  
Coronary Syndrome ◽  
Increased Risk

Abstract Aims The value of platelet function testing (PFT) in predicting clinical outcomes and guiding P2Y12-inhibitor treatment is uncertain. In a pre-specified sub-study of the TROPICAL-ACS trial, we assessed ischaemic and bleeding risks according to high platelet reactivity (HPR) and low platelet reactivity (LPR) to ADP in patients receiving uniform prasugrel vs. PFT-guided clopidogrel or prasugrel. Methods and results Acute coronary syndrome patients with PFT done 14 days after hospital discharge were included with prior randomization to uniform prasugrel for 12 months (control group, no treatment modification) vs. early de-escalation from prasugrel to clopidogrel and PFT-guided maintenance treatment (HPR: switch-back to prasugrel, non-HPR: clopidogrel). The composite ischaemic endpoint included cardiovascular death, myocardial infarction, or stroke, while key safety outcome was Bleeding Academic Research Consortium (BARC) 2–5 bleeding, from PFT until 12 months. We identified 2527 patients with PFT results available: 1266 were randomized to the guided and 1261 to the control group. Before treatment adjustment, HPR was more prevalent in the guided group (40% vs. 15%), while LPR was more common in control patients (27% vs. 11%). Compared to control patients without HPR on prasugrel (n = 1073), similar outcomes were observed in guided patients kept on clopidogrel [n = 755, hazard ratio (HR): 1.06 (0.57–1.95), P = 0.86] and also in patients with HPR on clopidogrel switched to prasugrel [n = 511, HR: 0.96 (0.47–1.96), P = 0.91]. In contrast, HPR on prasugrel was associated with a higher risk for ischaemic events in control patients [n = 188, HR: 2.16 (1.01–4.65), P = 0.049]. Low platelet reactivity was an independent predictor of bleeding [HR: 1.74 (1.18–2.56), P = 0.005], without interaction (Pint = 0.76) between study groups. Conclusion Based on this substudy of a randomized trial, selecting prasugrel or clopidogrel based on PFT resulted in similar ischaemic outcomes as uniform prasugrel therapy without HPR. Although infrequent, HPR on prasugrel was associated with increased risk of ischaemic events. Low platelet reactivity was a strong and independent predictor of bleeding both on prasugrel and clopidogrel.

scholarly journals Effects of Fatty Acid Therapy in Addition to Strong Statin on Coronary Plaques in Acute Coronary Syndrome: An Optical Coherence Tomography Study

2020 ◽  
Vol 9 (16) ◽  
Author(s):  
Yoko Kita ◽  
Makoto Watanabe ◽  
Daisuke Kamon ◽  
Tomoya Ueda ◽  
Tsunenari Soeda ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Acute Coronary Syndrome ◽  
Fatty Acid ◽  
Statin Therapy ◽  
Control Group ◽  
Optical Coherence ◽  
Acid Therapy ◽  
Coronary Syndrome ◽  
Percent Change

BACKGROUND Vascular healing response associated with adjunctive n‐3 polyunsaturated fatty acid therapy therapy in patients receiving strong statin therapy remains unclear. The aim of this study was to evaluate the effect of polyunsaturated fatty acid therapy with eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) in addition to strong statin therapy on coronary atherosclerotic plaques using optical coherence tomography. METHODS AND RESULTS This prospective multicenter randomized controlled trial included 130 patients with acute coronary syndrome treated with strong statins. They were assigned to either statin only (control group, n=42), statin+high‐dose EPA (1800 mg/day) (EPA group, n=40), statin+EPA (930 mg/day)+DHA (750 mg/day) (EPA+DHA group, n=48). Optical coherence tomography was performed at baseline and at the 8‐month follow‐up. The target for optical coherence tomography analysis was a nonculprit lesion with a lipid plaque. Between baseline and the 8‐month follow‐up, fibrous cap thickness (FCT) significantly increased in all 3 groups. There were no significant differences in the percent change for minimum FCT between the EPA or EPA+DHA group and the control group. In patients with FCT <120 µm (median value), the percent change for minimum FCT was significantly higher in the EPA or EPA+DHA group compared with the control group. CONCLUSIONS EPA or EPA+DHA therapy in addition to strong statin therapy did not significantly increase FCT in nonculprit plaques compared with strong statin therapy alone, but significantly increased FCT in patients with thinner FCT. Registration URL: https://www.umin.ac.jp/ctr/ ; Unique identifier: UMIN 000012825.

Depression in Acute Coronary Syndrome

2003 ◽  
Vol 93 (3_suppl) ◽  
pp. 1105-1108 ◽  
Author(s):  
Damir Kozmar ◽  
Katija Čatipović-Veselica ◽  
Andrea Galić ◽  
Jasna Habek
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Ventricular Fibrillation ◽  
Good Prognosis ◽  
Left Ventricular ◽  
Control Group ◽  
Coronary Syndrome ◽  
Mean Differences ◽  
And Control

This study examined the prevalence of depression based on scores of 200 patients with acute coronary syndrome on the Emotion Profile Index of Plutchik and its relationship with the type of acute coronary syndrome and the severity of ischemic heart disease. Patients with acute coronary syndrome scored higher on depression than the control group. There was no difference in scores on Depression by type of acute coronary syndrome and no significant mean differences on Depression for patients with and without left ventricular failure. Patients with acute myocardial infarction and ventricular fibrillation scored lower on Depression than other patients with acute myocardial infarction and control group. This study supports the view that patients with acute myocardial infarction and ventricular fibrillation and lower scores on Depression have good prognosis during hospitalization and maybe for the long term.

ALGORITHM TO STRATIFY THE RISK OF MYOCARDIAL INFARCTION IN PATIENTS WITH ACUTE CORONARY SYNDROME AT PRIMARY EXAMINATION

2020 ◽  
Vol 65 (6) ◽  
pp. 394-400
Author(s):  
A. S. Pushkin ◽  
D. Shulkin ◽  
L. V. Borisova ◽  
T. A. Akhmedov ◽  
S. A. Rukavishnikova
Keyword(s):  
Machine Learning ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Troponin I ◽  
Final Diagnosis ◽  
Blood Analysis ◽  
Digital Data ◽  
Control Group ◽  
Laboratory Diagnostics ◽  
Coronary Syndrome

The episode of acute coronary syndrome is most often preceded by the development of systemic and local inflammation, which plays a significant role in the pathogenesis of the disease. General clinical blood analysis, directly or indirectly reflecting systemic pathological processes in the patient’s body based on quantitative and morphological assessment of blood composition, is one of the most affordable methods of laboratory diagnostics in modern public health. Taking into account the growing number of digital data obtained by diagnosticians from analytical systems, there is a growing potential for the use of machine learning methods to increase the effectiveness of provided diagnostic information in the interests of the patient. The aim of this study was to create an algorithm for stratifying the risk of myocardial infarction based on the methods of machine learning in patients with acute coronary syndrome at primary examination. A prospective pilot study was conducted. In total 307 patients with acute coronary syndrome (169 men and 138 women) were examined. The average age of patients was 68.6 ± 12.5 years. Retrospectively, the patients were divided into two groups: the main group - patients with the final diagnosis “Myocardial infarction” and the control group with the diagnosis “Unstable angina pectoris”. All patients at hospitalization at the primary laboratory examination along with the study of the concentration of cardiac troponin I by a highly sensitive method were examined by a general clinical blood analysis on an automatic hematological 5-diff analyzer. As a result of the application of the ensemble method as a method of machine learning and artificial neural networks as 6 independent models of the ensemble it was possible to achieve the area under the ROC curve = 0.77 on the test set when assessing the quality of patient stratification. Taking into account the volume of the training sample in 214 patients and the results of similar studies, the achieved stratification quality can be considered acceptable and promising for further accumulation of the database with the purpose of additional training of the developed algorithm and improvement of the disease prognosis accuracy characteristics.

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