Cardiovascular Events
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2021 ◽  
Vol 20 (7) ◽  
pp. 3060
S. N. Tolpygina ◽  
S. Yu. Martsevich ◽  
A. D. Deev

Aim. To develop a risk stratification scale for predicting cardiovascular events (CVEs) in patients with chronic coronary artery disease (CAD) based on the data from the PROGNOZ IBS registry.Material and methods. The PROGNOZ IBS registry included 641 patients (men, 500; women, 141) living in Moscow and the Moscow Region, who were routinely admitted to the National Medical Research Center for Therapy and Preventive Medicine from January 1, 2004 to December 31, 2007 with a preliminary diagnosis of CAD. All included participants underwent coronary angiography during hospitalization. The diagnosis of CAD was verified in 84% of patients. The vital status was established in 551 (86%) patients in 2010 and 583 (92%) in 2014. The follow-up period was 7 years. A multivariate statistical analysis of the predictive value of data obtained during primary hospitalization was carried out.Results. The enhanced risk stratification scale included factors with the highest predictive value for developing CVEs. The presence of NYHA class III-IV heart failure increased the relative risk of CVEs by 5,4 times (3 points), atherosclerotic aortic stenosis by 2,8 times (2 points), stroke by 2,3 times (3 points), a confirmed diagnosis of CAD by 1,7 times (1  point), the presence of dyspnea by 1,4 times (1 point), unstable CAD course in the last 3 months by 1,4 times (1 point), taking diuretics before hospitalization by 1,9 times (1 point), left ventricular ejection fraction of 40-60% and left ventricular diastolic dysfunction according to echocardiography by 1,9 and 2 times (1 point each), respectively, an increase in the heart rate according resting electrocardiography >90 bpm by 1,7 times (1 point), the presence of chronic lung disease or renal failure by 1,5 times (1 point). Seven-year risk of fatal and nonfatal CVEs in patients with CAD in case of score of 0-3 is considered low, score of 4-5 points — moderate (increase in CVE risk by 3 times), score of ≥6 — high (increase in CVE risk by 9 times).Conclusion. The enhanced risk stratification scale allows predicting the risk of fatal and non-fatal CVC in patients with suspected and confirmed CAD and may be used for widespread use due to informative value, simplicity and availability.

2021 ◽  
Vol 11 (1) ◽  
Shih-Yuan Hung ◽  
Tsun-Mei Lin ◽  
Hung-Hsiang Liou ◽  
Ching-Yang Chen ◽  
Wei-Ting Liao ◽  

AbstractA mild decrease of ADAMTS13 (a disintegrin and metalloprotease with thrombospodin type 1 motif 13) could attribute to stroke and coronary heart disease in general population. However, the role of ADAMTS13 in hemodialysis (HD) patients remains to be explored. This cross-sectional and observational cohort study enrolled 98 chronic HD patients and 100 normal subjects with the aims to compare the ADAMTS13 activity between chronic HD patients and normal subjects, and to discover the role of ADAMTS13 on the newly developed cardiovascular events for HD patients in a 2-year follow-up. Our HD patients had a significantly lower ADAMTS13 activity than normal subjects, 41.0 ± 22.8% versus 102.3 ± 17.7%, p < 0.001. ADAMTS13 activity was positively correlated with diabetes, triglyceride and hemoglobin A1c, and negatively with high-density lipoprotein cholesterol levels in HD patients. With a follow-up of 20.3 ± 7.3 months, the Cox proportional hazards model revealed that low ADAMTS13, comorbid diabetes, and coronary heart diseases have independent correlations with the development of cardiovascular events. Our study demonstrated that chronic HD patients have a markedly decreased ADAMTS13 activity than normal subjects. Although ADAMTS13 seems to correlate well with diabetes, high triglyceride and low high-density lipoprotein cholesterol levels, ADAMTS13 deficiency still carries an independent risk for cardiovascular events in chronic HD patients.

Fanny Jansson Sigfrids ◽  
Lars Stechemesser ◽  
Emma H. Dahlström ◽  
Carol M. Forsblom ◽  
Valma Harjutsalo ◽  

Efrén Martínez‐Quintana ◽  
Javier Pardo‐Maiza ◽  
Beatriz Déniz‐Alvarado ◽  
Marta Riaño‐Ruiz ◽  
Jesús María González‐Martín ◽  

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Ying Li ◽  
Li Li ◽  
Kun Wang ◽  
Pengtao Wu ◽  
Yijie Cui

Objective. The aim of this study was at investigating the risk stratification and prognostic value of hypersensitive troponin T (hs-TnT) combined with matrix metalloproteinase 2 (MMP-2) in patients with acute coronary syndrome (ACS). Methods. 80 patients with coronary syndrome admitted to our hospital from January 2019 to January 2020 and 40 healthy people (control group) in the same period were selected. According to different types of diseases, the patients were divided into an acute group ( n = 40 ) and stable group ( n = 40 ). Besides, they all were monitored by the hs-TnT value, serum MMP-2, and coronary angiography at admission and the comparative analysis was carried out. The patients in both groups were followed up for 30 days, and the incidence of adverse cardiovascular events in the patients during this period was recorded. Results. Compared with those in the control group, the MMP-2 and hs-TnT levels in the acute group and the stable group were significantly higher and the MMP-2 and hs-TnT levels in the acute group were significantly higher than those in the stable group, with statistically significant differences ( P < 0.05 ). The 30-day follow-up results showed that the incidence of adverse cardiovascular events in the acute group was significantly higher than that in the stable group, with statistically significant differences ( P < 0.05 ). The hs-TnT and MMP-2 levels in the acute myocardial infarction (AMI) group were significantly higher than those in the unstable angina pectoris (UAP) group, with statistically significant differences ( P < 0.01 ). The hs-TnT and MMP-2 levels in the non-single-vessel group were significantly higher than those in the single-vessel group, with statistically significant differences ( P < 0.01 ). Conclusion. The hs-TnT and MMP-2 high expression levels are closely associated with myocardial injury, and they can effectively predict the severity of patients’ disease. In addition, the hs-TnT and MMP-2 elevated levels can be considered as an important index to judge the short-term treatment efficacy and the risk stratification of early ACS, playing an important role in clinical treatment and rehabilitation in the later stage.

2021 ◽  
Vol 6 (5) ◽  
pp. 245-252
A. G. Polupanov ◽  
A. U. Mamatov ◽  
M. T. Duishenalieva ◽  
A. T. Аrykova ◽  
F. T. Rysmatova ◽  

Background. Currently, obesity has become one of the most important medical and social problems in the world due to its high prevalence. Numerous literature data indicate that high BMI is associated with increased mortality from cardiovascular diseases.The aim: to study the relationship between overweight and generalized obesity with the development of fatal and non-fatal cardiovascular events among residents of the Chui region of the Kyrgyz Republic, taking into account gender and age.Material and methods. This study was carried out as part of the international crosssectional epidemiological study “Interepid”. The total follow-up period was 7 years. Life status at the end of the follow-up period was monitored in 1096 respondents out of 1341 initial cohorts (response – 82.1 %). The endpoints were cases of fatal and non-fatal cardiovascular events. The frequency of events was assessed using methods of analysis of survival (Cox proportional hazard regression model, parametric survival models, survival by the Kaplan – Meier method).Results. A total of 181 cases of fatal and non-fatal cardiovascular events (16.44 %) were recorded during the follow-up. In persons with normal body weight, the incidence of cardiovascular complications was 10 %. In overweight individuals, the value of this indicator increased and reached 17.99 % (p˂ 0.001), and in individuals with obesity – 24.5 % (p˂ 0.0001). The increase in the frequency of events with the increase in body mass index did not depend on the gender of the respondents but was typical only for people under 60 years of age. For elderly patients, there was no relationship between BMI and the development of cardiovascular complications. In contrast, the relative risk had an insignificant tendency to decrease by 2.6 % for every 1 kg/m2 increase in body mass index (RR – 0.974; 95% CI: 0.924–1.025).Conclusion. The increase of body mass index above 25 kg/m2 is an independent risk factor for the development of fatal and non-fatal cardiovascular events in the analyzed cohort of the Chui region residents, regardless of gender, but only in persons under 60 years of age. 

2021 ◽  
Vol 22 (22) ◽  
pp. 12590
Giuseppina Crugliano ◽  
Raffaele Serra ◽  
Nicola Ielapi ◽  
Yuri Battaglia ◽  
Giuseppe Coppolino ◽  

Anemia is a common complication of chronic kidney disease (CKD). The prevalence of anemia in CKD strongly increases as the estimated Glomerular Filtration Rate (eGFR) decreases. The pathophysiology of anemia in CKD is complex. The main causes are erythropoietin (EPO) deficiency and functional iron deficiency (FID). The administration of injectable preparations of recombinant erythropoiesis-stimulating agents (ESAs), especially epoetin and darbepoetin, coupled with oral or intravenous(iv) iron supplementation, is the current treatment for anemia in CKD for both dialysis and non-dialysis patients. This approach reduces patients’ dependence on transfusion, ensuring the achievement of optimal hemoglobin target levels. However, there is still no evidence that treating anemia with ESAs can significantly reduce the risk of cardiovascular events. Meanwhile, iv iron supplementation causes an increased risk of allergic reactions, gastrointestinal side effects, infection, and cardiovascular events. Currently, there are no studies defining the best strategy for using ESAs to minimize possible risks. One class of agents under evaluation, known as prolyl hydroxylase inhibitors (PHIs), acts to stabilize hypoxia-inducible factor (HIF) by inhibiting prolyl hydroxylase (PH) enzymes. Several randomized controlled trials showed that HIF-PHIs are almost comparable to ESAs. In the era of personalized medicine, it is possible to envisage and investigate specific contexts of the application of HIF stabilizers based on the individual risk profile and mechanism of action.

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