scholarly journals Short-term Prognostic Value of Admission Cardiac Troponin T, C-Reactive Protein and Echocardiographic Regional Wall Motion Abnormalities in Patients with Acute ST Elevation Myocardial Infarction

2021 ◽  
Author(s):  
Pooja Dhaon ◽  
Dharmendra Uraiya ◽  
Neeraj Tripathi
Keyword(s):  
Cardiac Troponin ◽  
Troponin T ◽  
Regional Wall Motion ◽  
Cardiac Troponin T ◽  
Reactive Protein ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Introduction: With increasing burden of Coronary Artery Disease (CAD) and ST-Elevation Myocardial Infarction (STEMI) in India, early risk stratification of patients is as important as making a correct diagnosis. Cardiac Troponin T (cTnT), C-Reactive Protein (CRP) and echocardiographic Regional Wall Motion Abnormalities (RWMA) are used to assess the patients of STEMI at presentation. The short term prognostic importance of these parameters also need to be known. Aim: To study the prognostic values of admission Cardiac Troponin T (cTnT), CRP and echocardiographic RWMA in patients with acute STEMI. Materials and Methods: Fifty patients of STEMI were evaluated from January 2017 to July 2017 by Troponin-T (positive >0.18 ng/mL), CRP (positive >3 mg/l) and echocardiography (positive with presence of RWMA) on day one. The patients were divided into three groups: Group 1: patients with all the three parameters positive, Group 2: patients with all three parameters negative, Group 3: patients with one or two parameters positive. The end points observed were heart failure Left Ventricular Ejection Fraction (LV EF) <40%) assessed by echocardiography at day 28, significant ventricular ectopics (>class II by Lown’s classification) and mortality at day 30 in the groups. Chi-square test for equality of proportions was used to analyse the difference in outcome in the groups. Results: The mean age of patients was 54 years. There were 25 (50%) patients in group 1, 14 (28%) patients in group 2 and 11 (22%) patients in group 3. Twelve (24%) patients had heart failure with 9 (18%) in group 1 and 3 (6%) in group 3 (p<0.05). 9 (18%) patients had significant ventricular ectopics with 8 (16%) patients in group 1 and 1 (2%) patients in group 3 (p<0.05). Mortality was found in 9 (18%) patients with 8 (16%) patients in group 1 and 1 (2%) patients in group 3 (p<0.05). Conclusion: Acute STEMI with high cTnT, CRP and presence of RWMA on echocardiography at admission need more aggressive management and close follow-up.

scholarly journals 1675 ABCDE vasodilator stress echocardiography in non-ischemic heart failure

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
N Kuznetsova ◽  
C Borguezan Daros ◽  
H Zanella ◽  
Q Ciampi ◽  
L Cortigiani ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Stress Echocardiography ◽  
Wall Motion ◽  
Regional Wall Motion ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities ◽  
Group 3 ◽  
Group 2 ◽  
Positivity Criterion ◽  
Group 1

Abstract OnBehalf Stress Echo 2020 study group of the Italian Society of Cardiovascular Imaging Background ABCDE-stress echocardiography (SE) may explore different aspects in the heterogeneous entity of known or suspected heart failure (HF). Aim To assess ABCDE-vasodilator SE in non-ischemic HF Methods In a prospective, observational, multicenter study, we recruited 428 patients with angiographically normal coronary arteries: 148 patients with HF and preserved (&gt;50%) ejection fraction (HFpEF, Group 1); 100 with HF and mid-range (40-50%) ejection fraction (HFmrEF, Group 2); 180 with HF and reduced (&lt;40%) ejection fraction (HFrEF, Group 3). A group of 75 healthy asymptomatic patients (30 male, 40%, age 57 ± 14 years) referred to testing for screening was also selected (Controls). All patients underwent vasodilator SE with dipyridamole (0.84 mg/kg) in 14 accredited laboratories of 5 countries (Argentina, Brasil, Russian Federation, Serbia and Italy). The ABCDE-SE protocol was adopted: A for regional wall motion abnormalities; B for B-lines (positivity criterion: stress ≥ rest for ≥ 2 points in a 4-site simplified scan available in 181 pts and 10 controls); C for left ventricular contractile reserve (LVCR) based on force (systolic blood pressure/end-systolic volume, positivity criterion: peak/ rest ≤1.1); D for pulsed wave Doppler-based assessment of coronary flow velocity reserve (CFVR) in left anterior descending coronary artery (positivity criterion: peak/rest ≤2.0); E for EKG-based assessment of heart rate reserve (positivity criterion: peak/rest ≤1.22). Results All positivity criteria, except A, were more prevalent (p&lt;.01) in Group 3 compared to Group 2, in Group 2 compared to Group 1, and Group 1 compared to controls: see figure. In particular, a blunted heart rate reserve was found in 4/75 controls (5%), 27/148 pts of Group 1 (18%), 28/100 of Group 2 (28%) and 98/180 of Group 3 (54%). Conclusions ABCDE-vasodilator SE can help to identify the profound pathophysiological heterogeneity underlying a similar clinical presentation in patients with known or suspected HF with angiographically normal coronary arteries. These patients rarely show stress-induced regional wall motion abnormalities (A), but may exhibit pulmonary congestion (B), reduced myocardial functional reserve (C), altered coronary microcirculation (D) and cardiac autonomic dysfunction (E). Abstract 1675 Figure. The positivity rate of ABCDE criteria

P1506Pulmonary decongestion pattern during stress lung ultrasound

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R O Arbucci ◽  
M C Scali ◽  
A Zagatina ◽  
L Cortigiani ◽  
A D'Andrea ◽  
...  
Keyword(s):  
Wall Motion ◽  
Lung Ultrasound ◽  
Regional Wall Motion ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities ◽  
Stress Score ◽  
Group 2 ◽  
Artery Disease ◽  
B Lines ◽  
Group 1

Abstract Background B-profile detected by lung ultrasound (LUS) during stress echocardiography (SE) consists in B-lines with lung sliding and mirrors extra-vascular lung water accumulation (“wet lung”), more often found with ischemic regional wall motion abnormalities (RWMA) and/or diastolic dysfunction. B-lines present at rest may also decrease during stress. Aim To assess the frequency and functional correlates of decreasing B-profile (“drying lung” pattern) during SE. Methods We prospectively performed transthoracic echocardiography (TTE) and LUS evaluation at rest and peak stress in 780 patients with B-lines at rest referred for exercise (n=387), vasodilator (n=324) or dobutamine (n=69) SE for known/suspected coronary artery disease (CAD) and/or heart failure (HF). Recruitment occurred in 17 certified labs of 8 countries with the ABCD protocol, including regional wall motion abnormalities with wall motion score index (WMSI), B-lines, left ventricular contractile reserve (LVCR based on force, systolic blood pressure/end-systolic volume) and Doppler-based coronary flow velocity reserve (CFVR, available in 473 patients). By LUS, we adopted the 4-site simplified scan, each site scored from 0=normal A-lines, to 10=coalescing B-lines. By selection, all patients had resting B-lines score ≥2. Invasive or noninvasive coronary angiography was available in 208 patients. Results Two B-lines stress patterns were identified: Group 1, increase or unchanged pattern (B-line stress score ≥ rest, n=698, 89%); Group 2, decrease-disappearance pattern (B-line stress score < rest for ≤2 points, n=82, 11%). Group 1 showed higher prevalence of inducible ischemia (Group 1 = 74/698 vs. Group 2 = 5/82, 11% vs. 6%, p<0.001), abnormal LVCR (Group 1 = 403/698 vs. Group 2 = 36/82, 58% vs. 42%, p=0.012) and impaired CFVR (Group 1 = 173/433 vs. Group 2 = 5/40, 40 vs. 12%, p<0.001): see figure. Two- or three-vessel coronary artery disease was also more frequent in fixed-worsening pattern (Group 1 = 88/191 vs. Group 2 = 3/17, 46 vs. 17%, p=0.024). Multivariate logistic regression analysis identified peak Force (Odds Ratio, OR, 1.039, 95% Confidence Intervals, CI: 1.006–1.074, P=0.022), stress-rest Δ-WMSI (OR 0.190, 95% CI 0.086–0.419, P<0.001) and normal CFVR (OR=1.754, 95% CI: 1.147–2.682, P=0.010) as significant predictors of drying lung pattern. Disappearing BLines Conclusion About one out of 10 patients with resting B-lines exhibit a decrease-disappearance pattern during stress. They show a more benign coronary anatomic, myocardial functional and coronary physiological profile compared to patients with the fixed-worsening pattern. The drying lung pattern is more often accompanied by a strong (higher peak force), non-ischemic and warm heart (with normal CFVR).

scholarly journals Impact of Persistent Left Ventricular Regional Wall Motion Abnormalities in Childhood Cancer Survivors after Anthracycline Therapy: Assessment of Global Left Ventricular Myocardial Performance By 3D Speckle-Tracking Echocardiography

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1274-1274
Author(s):  
Hirotsugu Okuma ◽  
Hiroshi Yagasaki ◽  
Katsuyoshi Shimozawa ◽  
Hideo Mugishima ◽  
Nobutaka Noto
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Regional Wall Motion ◽  
Childhood Cancer Survivors ◽  
Left Ventricular ◽  
Myocardial Performance ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities ◽  
Group 2 ◽  
Group 1

Abstract Background: Previous studies of childhood cancer survivors demonstrated the existence of transient or persistent left ventricular (LV) regional wall motion abnormalities (WMA) after treatment with anthracyclines, but the differential impact on deformation of persistent regional WMA against global LV myocardial performance is unknown. Methods: To investigate whether childhood cancer survivors after treatment with anthracyclines with persistent LV regional WMA have a poorer LV myocardial performance compared to those without WMA, 34 long-term childhood cancer survivors (mean age 14.6±4.0 years) with a median cumulative anthracycline dose 234.7mg/m2 (range 80-625mg/m2) who had been off treatment for ≥ 5 years and a preserved LV ejection fraction (EF) (>55%), and 12 healthy control subjects, were studied by using 3D speckle-tracking echocardiography (3D STE). The 34 patients were divided into two groups according to the existence of regional WMA: group 1 (with WMA, n=14), group 2 (without WMA, n=20). 3D STE was performed to assess LV global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), global area strain (GAS), LV torsion, LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), LVEF, and LV systolic dyssynchrony index (SDI: % of SD of time to peak of the 16-segment/R-R interval). Results: Of the 14 patients with WMA, regional WMA was seen at mid-anterior septum in 13 patients (92.8%) and apical septum in 1 patient (7.2%). There was no statistical difference in LVEDV, LVESV, LVEF, GLS, LV torsion or SDI derived from GLS, GCS, GAS among the 3 groups. In contrast, there were significant differences in GRS (p<0.001), GAS (p<0.018), GCS (p<0.025), and SDI derived from GRS (p<0.01) among the 3 groups. Compared with group 2, group 1 had significantly reduced GRS (14.3±6.1% vs. 33.1±10.1%, p=0.003), GCS (-23.5±3.7% vs. -33.9±6.5%, p=0.026), GAS (-34.3±5.1% vs. -45.41±6.6%, p=0.034, respectively), and greater SDI derived from GRS (16.5±5.1% vs. 6.9±2.9%, p<0.01, respectively). Moreover, existence of WMA was correlated with GRS (p<0.0001), SDI derived from GRS (p<0.0001), LVEF (p=0.036), and cumulative dose (p=0.049). Multiple linear regression analysis identified GRS as a significant determinant of the existence of WMA (β=0.751, p=0.001). Conclusion: Childhood cancer survivors after anthracycline therapy with persistent regional WMA show a poorer LV myocardial performance with mechanical dyssynchrony compared to those without regional WMA, despite a preserved LVEF. Disclosures No relevant conflicts of interest to declare.

scholarly journals Cardiac Troponin T and I in End-Stage Renal Failure

2000 ◽  
Vol 46 (9) ◽  
pp. 1345-1350 ◽  
Author(s):  
Diana Wayand ◽  
Hannsjörg Baum ◽  
Gabriele Schätzle ◽  
Julia Schärf ◽  
Dieter Neumeier
Keyword(s):  
Renal Failure ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Cardiac Complications ◽  
Cardiac Troponin T ◽  
End Stage Renal Failure ◽  
History Of ◽  
Group 2 ◽  
End Stage ◽  
Group 1

Abstract Background: In patients suffering from end-stage renal failure, cardiac troponin T (cTnT) and I (cTnI) may be increased in serum without other signs of acute myocardial damage. Whether these increases are specific to myocardial injury or nonspecific is not completely clear. Methods: We investigated time courses of cTnT and cTnI over 1 year and the clinical outcome over 2 years in 59 patients with end-stage renal failure undergoing chronic hemodialysis. At the start of the study, we divided the patients into two groups, group 1, without history of cardiac failure, and group 2, with history of cardiac failure, and looked for differences between the groups in later adverse outcome. cTnT was measured using the Enzymun® troponin T assay on an ES 700 analyzer (Roche). cTnI was measured on a Stratus® II analyzer (Dade Behring). Creatinine and blood urea nitrogen were measured on a Vitros® 950 IRC (Ortho). Results: Dialysis acutely increased cTnT (P &lt;0.01) and decreased cTnI (P &lt;0.001) regardless of the dialysis membrane used. Although statistically not significant, cTnT but not cTnI was increased more frequently in group 2 than in group 1, in some cases over the whole study period. Five patients (8.5%) died of cardiac complications within 2 years; all of them had mostly increased cTnT and, in one or more samples, increased cTnI. Conclusions: Dialysis alters measured cTnT and cTnI concentrations in serum. In patients suffering from end-stage renal failure, sporadic or persistently increased cTnT and cTnI appear to predict cardiac complications. Because of the effects of the dialysis procedure on troponin values, we recommend that blood be collected before dialysis.

P6246Three-year change in high-sensitivity cardiac troponin T and total mortality in older adults - The ActiFE Study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Dallmeier ◽  
U Braisch ◽  
M Denkinger ◽  
W Koenig ◽  
D Rothenbacher
Keyword(s):  
Older Adults ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Reference Group ◽  
Total Mortality ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Group 6 ◽  
Group 3 ◽  
Group 1

Abstract Background High sensitivity cardiac troponin-T (hs-cTnT) levels in asymptomatic older adults have been associated with adverse outcomes such as total mortality. In this context little is known about the implications of changes over time in this population. Purpose We aimed to investigate the three-year change of hs-cTnT and its association with subsequent total mortality in a cohort of community dwelling older adults. Methods We measured hs-cTnT at baseline (BL) and at three-year follow-up (FU) in participants at the Activity and Function in the Elderly (ActiFE) Study. Having those with BL und FU hs-cTnT <5 ng/L (undetectable) as the reference group (Group 1, n=156) five categories were built among those with an increment of hs-cTnT overtime: For those with undetectable BL: FU 5 to <14 ng/L (Group 2, n=295), FU ≥14 ng/L (Group 3, n=24). Among those with BL levels between 5 to <14 ng/L: FU 5 to <14 ng/L (Group 4, n=101), FU ≥14 ng/L (Group 5, n=96). Group 6 included those with BL and FU >14 ng/L (n=74). Using Cox proportional hazards models we evaluated the association between the identified groups and total mortality adjusting for age, sex, education, history of cardiovascular disease (CVD), chronic kidney disease (CKD), number of medications, CRP, and NT-proBNP measured at FU. Results Among 746 participants (median age at FU 75.9 years, 58.9% male) we observed a total of 98 deaths (median FU 4.8 years) with a mortality rate of 28.6 [95% CI 23.5, 34.9] per 1000 person-years. Those with undetectable hs-cTnT levels at both time point (Group 1, reference group) had the lowest mortality rate (5.2 [95% CI 2.0, 13.9] per 1000 person-years) and were noted to be most likely younger, women, with BMI ≥18.5 but <30 kg/m2, and had less comorbidities. The highest mortality rates were observed in i) those who went from undetectable levels at BL to FU levels ≥14 ng/L (Group 3: 95.4 [95% CI 49.6, 183.4] per 1000 person-years), and in ii) those with hs-cTnT levels >14 ng/L at both time points (Group 6: 100.4 [95% CI 69.8, 144.5] per 1000 person-years). These both groups showed the highest median hs-cTnT at FU (16.7 and 30.1 ng/L respectively), and the highest incidence proportion from BL to FU of CVD and CKD. Highest FU median levels of CRP were measured in Group 3, of NT-proBNP in Group 6. In the multivariable analysis we observed a significant increased hazard for total mortality with a hazard ratio of 5.62 [95% CI 1.57, 20.14] for those in Group 3 and 3.87 [95% CI 1.17, 12.80] for those in Group 6, when compared to the reference group. Conclusion Evaluating trajectories of hs-cTnT even in asymptomatic older adults could help to identify those subjects with a high risk to die even after adjustment for other covariates including NT-proBNP. Further research is needed in order to identify pathophysiological mechanisms behind these changes in older adults, and the possible effect of preventive measures in the identified risk groups. Acknowledgement/Funding This work was supported by a grant from the Ministry of Science, Research and Arts, state of Baden-Wuerttemberg, Germany.

scholarly journals Fever as a predictor of adverse outcomes in COVID-19

QJM ◽  
2021 ◽  
Author(s):  
N W Chew ◽  
J N Ngiam ◽  
S M Tham ◽  
Z Y Lim ◽  
T Y W Li ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Adverse Outcomes ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
End Point ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Design And Methods ◽  
Group 1

Summary Background/Introduction There are little data on outcomes of COVID-19 patients with the presence of fever compared to the presence of symptoms. Aim We examined the associations between symptomology, presence of fever and outcomes of a COVID-19 cohort. Design and Methods Between 23 January and 30 April 2020, 554 COVID-19 patients were admitted to a tertiary hospital in Singapore. They were allocated into four groups based on symptomology and fever—Group 1: asymptomatic and afebrile, Group 2: symptomatic but afebrile, Group 3: febrile but asymptomatic and Group 4: symptomatic and febrile. The primary outcomes were intensive care unit (ICU) admissions and mortality. The composite end-point included ICU admissions, mortality or any COVID-19 related end-organ involvement. Results There were differences in ferritin (P=0.003), C-reactive protein (CRP) levels (P&lt;0.001) and lymphopenia (P=0.033) across all groups, with the most favourable biochemical profile in Group 1, and the least in Group 4. Symptomatic groups (Groups 2 and 4) had higher ICU admissions (1.9% and 6.0%, respectively, P=0.003) than asymptomatic groups (Groups 1 and 3). Composite end-point was highest in Group 4 (24.0%), followed by Group 3 (8.6%), Group 2 (4.8%) and Group 1 (2.4%) (P&lt;0.001). The presence of fever (OR 4.096, 95% CI 1.737–9.656, P=0.001) was associated with the composite end-point after adjusting for age, pulse rate, comorbidities, lymphocyte, ferritin and CRP. Presence of symptoms was not associated with the composite end-point. Discussion/Conclusion In this COVID-19 cohort, presence of fever was a predictor of adverse outcomes. This has implications on the management of febrile but asymptomatic COVID-19 patients.

Factors associated with baseline and serial changes in circulating NT-proBNP and high-sensitivity cardiac troponin T in a population-based cohort (Dallas Heart Study)

2021 ◽  
Author(s):  
Christopher W Puleo ◽  
Colby R Ayers ◽  
Sonia Garg ◽  
Ian J Neeland ◽  
Alana A Lewis ◽  
...  
Keyword(s):  
Body Composition ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Cardiac Troponin T ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Heart Study ◽  
Dallas Heart Study

Aim: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) associate with structural heart disease and heart failure risk in individuals without known cardiovascular disease (CVD). However, few data are available regarding whether factors influencing levels of these two biomarkers are similar or distinct. We performed serial measurement of NT-proBNP and hs-cTnT in a contemporary multiethnic cohort with extensive phenotyping, with the goal of identifying their respective biological determinants in a population without known or suspected CVD. Methods: We evaluated 1877 participants of the Dallas Heart Study who had NT-proBNP and hs-cTnT measured and were free from clinical CVD at the each of its two examinations (2000–2002 and 2007–2009). Variables collected included demographic and risk factors, high-sensitivity C-reactive protein, body composition via dual-energy x-ray absorptiometry, coronary artery calcium by computed tomography, and cardiac dimensions and function by cardiac MRI. Linear regression was used to identify associations of these factors with each biomarker at baseline and with changes in biomarkers over follow-up. Results: NT-proBNP and hs-cTnT were poorly correlated at baseline (Spearman rho 0.083, p = 0.015), with only moderate correlation between change values (rho 0.18, p < 0.001). hs-cTnT positively associated and NT-proBNP inversely associated with male gender and black race. At baseline, both NT-proBNP and hs-cTnT associated with left ventricular end-diastolic volume and wall thickness, but only NT-proBNP associated with left atrial size. Changes in cardiac dimensions between phases were more strongly associated with changes in NT-proBNP than hs-cTnT. NT-proBNP was more strongly associated with high-sensitivity C-reactive protein and measures of body composition than hs-cTnT. Conclusion: Among individuals without CVD in the general population, NT-proBNP and hs-cTnT are nonredundant biomarkers that are differentially associated with demographic and cardiac factors. These findings indicate that hs-cTnT and NT-proBNP may reflect different pathophysiological pathways.

NT-proBNP, hs-cTnT, and CRP predict the risk of cardiopulmonary outcomes in systemic sclerosis: Findings from the Canadian Scleroderma Research Group

2021 ◽  
pp. 239719832110406
Author(s):  
Mayank Jha ◽  
Mianbo Wang ◽  
Russell Steele ◽  
Murray Baron ◽  
Marvin J Fritzler ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
Natriuretic Peptide ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk

Objective: The aim of this study was to determine the independent value of N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein to predict onset of cardiopulmonary disease in a large, multi-center systemic sclerosis cohort followed prospectively. Methods: Subjects from the Canadian Scleroderma Research Group registry with data on N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein were identified. Outcomes of interest were death, systolic dysfunction (left ventricular ejection fraction < 50% or medications for heart failure), pulmonary arterial hypertension by right heart catheterization, pulmonary hypertension by cardiac echocardiography (systolic pulmonary artery pressures ⩾ 45 mmHg), arrhythmias (pacemaker/implantable cardiac defibrillator or anti-arrhythmic medications), and interstitial lung disease. Multivariate Cox proportional hazard models were generated for each outcome. Results: A total of 675 subjects were included with a mean follow-up of 3.0 ± 1.8 years. Subjects were predominantly women (88.4%) with mean age of 58.2 ± 11.3 years and mean disease duration of 13.7 ± 9.1 years. One hundred and one (101, 15%) subjects died during follow-up, 37 (6.4 %) developed systolic dysfunction, 18 (2.9%) arrhythmias, 34 (5.1%) pulmonary arterial hypertension, 43 (7.3%) pulmonary hypertension, and 48 (12.3%) interstitial lung disease. In multivariate analyses, elevated levels of N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein were associated with increased risk of death, while elevated levels of N-terminal pro b-type natriuretic peptide and C-reactive protein were associated with increased risk of developing pulmonary hypertension. Conclusion: In systemic sclerosis, N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein have independent predictive value for death and pulmonary hypertension. A larger study would be required to determine the predictive value of these biomarkers for less common systemic sclerosis outcomes.

scholarly journals Association of Haemoglobin and C-Reactive Protein level with Different Risk Factors among Acute Coronary Syndrome Patients

2019 ◽  
Vol 5 (2) ◽  
pp. 156-160
Author(s):  
Md Mahboob Morshed ◽  
Md Joynul Islam ◽  
ATM Ashadullah ◽  
Khondker Shaheed Hussain ◽  
Mohammad Ahtashamul Haque
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Group 4 ◽  
History Of ◽  
Study Population ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Different risk factors may be related with the haemoglobin and CRP level among the acute coronary syndrome patients. Objective: The purpose of the present study was to see the association of haemoglobin and CRP level with different type of risk factors among the acute coronary syndrome patients. Methodology: This cross-sectional study was conducted in the Department of Cardiology at Mymensingh Medical College, Mymensingh, Bangladesh from December 2010 to November 2011 for a period of two (02) years. Patients of ACS who were presented within 12 hours of chest pain were included as study population. Study population were categorized in four groups according to the level of hemoglobin and C-reactive protein. Age, cardiovascular risks factor, history, family history of cardiovascular disease, treatment history and ECG were taken during admission. Blood sample was collected for baseline laboratory investigations like Troponin-I, Random Blood Sugar (RBS), Blood urea, Serum creatinine, lipid profile, Hemoglobin & CRP level. Sample were then send to standard laboratory/Biochemistry department of MMCH. Result: The mean age of the population was 52.18±8.88 years. Smoking was the highest percentage in Group 1 which was 54(50.0%) cases (P=0.001). Hypertension was found most common in group 1 (47.6%), Group 2 (33.3%), Group 3 (10.7%) and Group 4 (8.3%). Smoking (p=0.001) and hypertension (p=0.016) was found statistically significant. Diabetes was found in Group 1 (37.7%), Group 2 (43.5%), Group 3 (11.6%) and Group 4 (7.2%). Group 1 (50%) and Group 2 (50%) patients were dyslipidaemic. Family history of IHD was present group-1 (36.8%), Group 2 (44.7%), Group 3 (73.2%) and Group 4 (53%). Among the smoker patient 65.6% cases had CRP level ˃12 mg/l; 39.8% cases had CRP level ˂12mg/L. Among the nonsmoker 34.4% cases had CRP level ˃12mg/l and 60.2% cases had CRP level ˂12mg/L. The finding was statistically significant. Conclusion: In conclusion haemoglobin and CRP level is associated with different type of risk factors among the acute coronary syndrome patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 156-160

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