Recent advances in the diagnosis and management of acute myocardial infarction

Management of ROS and Regulatory Cell Death in Myocardial Ischemia-Reperfusion Injury

Myocardial ischemia-reperfusion injury (MIRI) is fatal to patients, leading to cardiomyocyte death and myocardial remodeling. Reactive oxygen species (ROS) and oxidative stress play important roles in MIRI. There is a complex crosstalk between ROS and regulatory cell deaths (RCD) in cardiomyocytes, such as apoptosis, pyroptosis, autophagy, and ferroptosis. ROS is a double-edged sword. A reasonable level of ROS maintains the normal physiological activity of myocardial cells. However, during myocardial ischemia-reperfusion, excessive ROS generation accelerates myocardial damage through a variety of biological pathways. ROS regulates cardiomyocyte RCD through various molecular mechanisms. Targeting the removal of excess ROS has been considered an effective way to reverse myocardial damage. Many studies have applied antioxidant drugs or new advanced materials to reduce ROS levels to alleviate MIRI. Although the road from laboratory to clinic has been difficult, many scholars still persevere. This article reviews the molecular mechanisms of ROS inhibition to regulate cardiomyocyte RCD, with a view to providing new insights into prevention and treatment strategies for MIRI.

Adenosine deaminase is a risk factor for mortality after discharge in patients with acute myocardial infarction: Long-term clinical follow-up

Background

Variations in adenosine deaminase (ADA) activity have been detected in numerous cardiovascular diseases (CVDs), but there is limited research on its role in the prognosis of CVDs. In this study, we explored the role of ADA in the prognosis of patients with acute myocardial infarction (AMI).

Method

In this study, a total of 1,574 patients with a first diagnosis of acute myocardial infarction (AMI) were followed up for a median (interquartile range [IQR]) of 77.0 (50.0, 95.0) months after discharge. Cox proportional hazards regression models were used to identify factors that are substantially valuable for patient prognosis.

Results

During the follow-up period, the mortality rate of AMI was 12.5 %. The 3-year and 5-year overall survival (OS) rates of AMI patients were 93.8 % and 91.0 %, respectively. Multivariate Cox regression analysis revealed that serum ADA (hazard ratio [HR] = 1.166, 95 % confidence interval [CI]: 1.006-1.352) was an independent risk factor for 5-year OS after discharge in AMI patients. When serum ADA was assessed in quartiles, compared with the reference group (Quartile 1), the adjusted HR for death was 2.498 (95 % CI: 1.344-4.642) in Quartile 4 for 5-year OS and 2.508 (95 % CI: 1.145-5.496) in Quartile 4 for 3-year OS.

Conclusions

Serum ADA levels at admission are a risk factor that affects the long-term prognosis of AMI patients after hospital discharge.

RGD-modified ZIF-8 nanoparticles as a drug carrier for MR imaging and targeted drug delivery in myocardial infarction

Aim: A multifunctional nanoplatform has been developed to enhance the targeting capability and biosafety of drug/siRNA for better diagnosis and treatment of myocardial infarction (MI).Materials & methods: The nanoplatform's chemical properties, biodistribution, cardiac magnetic resonance imaging (MRI) capabilities, therapeutic effects and biocompatibility were investigated.Results: The nanoplatform exhibited MI-targeting properties and pH-sensitivity, allowing for effective cardiac MRI and delivery of drugs to the infarcted myocardium. The GCD/Qt@ZIF-RGD demonstrated potential as a reliable MRI probe for MI diagnosis. Moreover, the GCD/si-SHP1/Qt@ZIF-RGD effectively suppressed SHP-1 expression, increased pro-angiogenesis gene expression and reduced cell apoptosis in HUVECs exposed to hypoxia/reoxygenation.Conclusion: Our newly developed multifunctional drug delivery system shows promise as a nanoplatform for both the diagnosis and treatment of MI.