1
|
Zehir R, Yılmaz AS, Çırakoğlu ÖF, Kahraman F, Duman H. Modified Glasgow Prognostic Score Predicted High-Grade Intracoronary Thrombus in Acute Anterior Myocardial Infarction. Angiology 2024; 75:454-461. [PMID: 36799537 DOI: 10.1177/00033197231157929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
High-grade intracoronary thrombus (ICT) burden leads to greater myocardial injury following anterior myocardial infarction (MI). The modified Glasgow prohgnostic score (mGPS) is a novel immune-inflammatory index, calculated by using C-reactive protein (CRP) and albumin levels, was shown to have prognostic value in heart diseases. The present study investigated the role of mGPS in predicting high grade ICT in patients with acute anterior MI admitted between February 2017 and March 2020. Blood samples were obtained at admission and mGPS was calculated. The ICT burden was evaluated visually from angiographic images. Patients were divided into 2 groups according to the ICT burden as high and low. A total of 1132 patients were enrolled: a mean age 61 ± 12.4 years and 370 males (32.7%). Serum albumin was lower, whereas mGPS and CRP were higher in high grade ICT group. CRP (odds ratio (OR): 1.404 95% CI: 1.312-1.502; P < .001), albumin (OR: .486; 95% CI: .301-.782 P < .001), and mGPS (0 vs ≥ 1) (OR: 7.391; 95% CI: 3.910-13.972; P < .001) were independent predictors of high-grade ICT burden in the left anterior descending coronary artery. The mGPS is a novel predictor of high-grade ICT burden and may be useful for risk stratification in patients with acute anterior MI.
Collapse
Affiliation(s)
- Regayip Zehir
- Department of Cardiology, University of Medical Sciences, İstanbul, Turkey
| | | | - Ömer Faruk Çırakoğlu
- Department of Cardiology, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey
| | - Fatih Kahraman
- Department of Cardiology, Evliya Çelebi Training and Research Hospital, Kütahya, Turkey
| | - Hakan Duman
- Department of Cardiology, Recep Tayyip Erdogan University, Rize, Turkey
| |
Collapse
|
2
|
Caldeira D, Rodrigues B, David C, Costa J, Pinto FJ, Ferreira JJ. The association of influenza infection and vaccine with myocardial infarction: systematic review and meta-analysis of self-controlled case series. Expert Rev Vaccines 2019; 18:1211-1217. [PMID: 31693865 DOI: 10.1080/14760584.2019.1690459] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Influenza vaccination may be beneficial in coronary disease patients; however the infection and vaccination are associated with acute inflammation, a trigger of cardiovascular events. We aimed to review the risk of myocardial infarction (MI) associated with Influenza infection and the safety of vaccination in self-controlled case series (SCCS).Methods: We performed a systematic review with meta-analysis of SCCS studies to evaluate the risk of MI associated with Influenza infection/vaccination. Database search was performed in August/2018. The data were reported using the incident rate ratio (IRR) and 95% confidence interval (95%CI).Results: three studies for Influenza infection and two studies for Influenza vaccination were eligible. The risk of MI following an Influenza infection was significantly increased in the first 3 days (IRR 5.79; 95%CI: 3.59-9.38) and between 4-7 days (IRR 4.52; 95%CI: 2.80-7.32). In the first 4 weeks following the Influenza vaccination, there was a significant decrease of MI risk (IRR 0.84, 95%CI: 0.78-0.91).Conclusions: Short-term MI risk in Influenza infection is significantly increased, with a low-to-moderate confidence in the pooled evidence. The Influenza vaccine was safe regarding the short-term risk for MI, and the risk reduction is possibly related to a healthy period bias.
Collapse
Affiliation(s)
- Daniel Caldeira
- Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, Serviço de Cardiologia, Hospital Universitário de Santa Maria (CHLN), CAML, Centro Cardiovascular da Universidade de Lisboa - CCUL, Lisboa, Portugal.,Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Avenida Professor Egas Moniz, Universidade de Lisboa, Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Avenida Professor Egas Moniz, Universidade de Lisboa, Lisboa, Portugal
| | - Bárbara Rodrigues
- Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Avenida Professor Egas Moniz, Universidade de Lisboa, Lisboa, Portugal
| | - Cláudio David
- Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, Serviço de Cardiologia, Hospital Universitário de Santa Maria (CHLN), CAML, Centro Cardiovascular da Universidade de Lisboa - CCUL, Lisboa, Portugal.,Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Avenida Professor Egas Moniz, Universidade de Lisboa, Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Avenida Professor Egas Moniz, Universidade de Lisboa, Lisboa, Portugal
| | - João Costa
- Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Avenida Professor Egas Moniz, Universidade de Lisboa, Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Avenida Professor Egas Moniz, Universidade de Lisboa, Lisboa, Portugal
| | - Fausto J Pinto
- Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, Serviço de Cardiologia, Hospital Universitário de Santa Maria (CHLN), CAML, Centro Cardiovascular da Universidade de Lisboa - CCUL, Lisboa, Portugal
| | - Joaquim J Ferreira
- Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Avenida Professor Egas Moniz, Universidade de Lisboa, Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Avenida Professor Egas Moniz, Universidade de Lisboa, Lisboa, Portugal
| |
Collapse
|
3
|
Plasma Chemerin Levels Are Increased in ST Elevation Myocardial Infarction Patients with High Thrombus Burden. Cardiol Res Pract 2018; 2018:5812704. [PMID: 29780640 PMCID: PMC5892252 DOI: 10.1155/2018/5812704] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 02/06/2018] [Indexed: 11/30/2022] Open
Abstract
Objective To investigate plasma chemerin levels in ST elevation myocardial infarction (STEMI) patients and find out possible relationships between plasma chemerin levels and angiographic characteristics. Patients and Methods Ninety-seven consecutive patients who presented with STEMI and underwent primary percutaneous coronary intervention (PCI) with coronary stents were enrolled, and 30 age- and sex-matched patients with stable angina pectoris who underwent coronary angiography formed the control group. Angiographic characteristics of the patients including thrombolysis in myocardial infarction (TIMI) thrombus and Gensini scores were noted. Blood samples were taken to detect several biochemical markers including plasma chemerin levels at the admission to hospital. Results Serum chemerin and C-reactive protein (CRP) levels were significantly increased in patients with STEMI. Among STEMI patients, serum chemerin levels were significantly higher in patients with high thrombus burden (581.5 ± 173.7 versus 451.3 ± 101.2 mg/dL, p < 0.001). CRP levels and peak creatine kinase-MB (CK-MB) levels were higher, and left ventricular ejection fraction and post-PCI TIMI flow were lower in patients with high thrombus burden. After multivariate analysis, serum chemerin levels were also higher in patients with high thrombus grade (odds ratio: 1.009 (1.005–1.014), p < 0.001). Besides, serum chemerin levels were also found to be significantly correlated with CRP (r=0.47, p < 0.001) and peak CK-MB (r=0.376, p < 0.001) levels. Conclusions Results from our study have demonstrated for the first time that chemerin levels were higher in STEMI patients with greater thrombus burden and higher level of inflammation.
Collapse
|
4
|
Cubedo J, Blasco A, Padró T, Ramaiola I, Juan-Babot O, Goicolea J, Fernández-Díaz J, Oteo J, Badimon L. Molecular signature of coronary stent thrombosis: oxidative stress and innate immunity cells. Thromb Haemost 2017. [DOI: 10.1160/th17-03-069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryThe clinical impact of in-stent thrombosis is high because it is associated with high mortality and 20 % of the patients suffer a recurrent event within the two following years. The aim of this study was to characterise the morphologic and proteomic profile of in-stent thrombi (IST) in comparison to thrombi developed on native coronary arteries (CT) to identify a differential molecular signature. The study included 45 patients with ST-elevation-myocardial-infarction (STEMI) treated by primary-percutaneous-intervention and thrombus aspiration: 21 had IST and 24 had CT. Thrombi were characterised by morphologic immunohistochemical analysis and differential proteomic profiling (2-DE+MALDI-TOF/TOF). Bioinformatic analysis revealed differences in proteins related to oxidative-stress and cell death/survival. IST showed a higher content of structural proteins (gelsolin, actin-cytoplasmic-1, tropomyosin, and myosin) together with an imbalance in redox-homeostasis related proteins (increased superoxide-dismutase and decreased peroxiredoxin-2 thrombus content), and a coordinated increase of chaperones (HSP60 and HSC70) and cellular quality control-related proteins (26S–protease-regulatory-subunit-7). These changes were reflected into a significant decrease in HSC70 systemic levels and a significant increase in advanced-oxidation-protein-products (AOPP) indicative of increased oxidative stress-mediated protein damage in IST. Our results reveal an imbalance in redox-related proteins indicative of an exacerbated oxidative-stress that leads to an accumulation of AOPP serum levels in IST. Moreover, the coordinated increase in chaperones and regulatory proteins reflects the activation of intracellular protection mechanisms to maintain protein integrity in IST. The failure to counterbalance the stress situation could trigger cellular apoptosis leading to the destabilization of the thrombus and to a worse prognosis of IST-STEMI-patients.Supplementary Material to this article is available online at www.thrombosis-online.com.
Collapse
|