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Biomarkers in acs

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https://www.readbyqxmd.com/read/28806444/eliminating-creatine-kinase-myocardial-band-testing-in-suspected-acute-coronary-syndrome-a-value-based-quality-improvement
#1
Matthew D Alvin, Allan S Jaffe, Roy C Ziegelstein, Jeffrey C Trost
Cardiac biomarker testing is estimated to occur in nearly 30 million emergency department visits nationwide each year in the United States. The American College of Cardiology/European Society of Cardiology indicate that cardiac troponin is the biomarker of choice owing to its nearly absolute myocardial tissue specificity and high clinical sensitivity for myocardial injury. Multiple academic medical centers have implemented interventions to eliminate the routine ordering of creatine kinase-myocardial band tests, with published patient safety outcomes data; however, creatine kinase-myocardial band testing is still ordered in many hospitals and emergency departments...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28804682/effects-of-intensive-pitavastatin-therapy-on-glucose-control-in-patients-with-non-st-elevation-acute-coronary-syndrome
#2
Yan-Bo Wang, Xiang-Hua Fu, Xin-Shun Gu, Wei-Ze Fan, Yun-Fa Jiang, Guo-Zhen Hao, Qing Miao, Jie Cao, Bing Fu, Yi Li
Objective: This study aimed to investigate the effects of intensive pitavastatin therapy on glucose control in patients with non-ST elevation acute coronary syndrome (ACS). Methods: Patients who had ACS with significant stenosis on initial coronary angiography and received successful percutaneous coronary intervention (PCI) in the Second Hospital of Hebei Medical University, Shijiazhuang, China from August 2015 to January 2016 were enrolled in this study. The patients were randomized to receive pitavastatin (4 mg daily) or atorvastatin (20 mg daily)...
2017: American Journal of Cardiovascular Disease
https://www.readbyqxmd.com/read/28796275/immature-platelets-as-a-novel-biomarker-for-adverse-cardiovascular-events-in-patients-after-non-cardiac-surgery
#3
Aida Anetsberger, Manfred Blobner, Bernhard Haller, Sebastian Schmid, Katrin Umgelter, Theresa Hager, Clemens Langgartner, Eberhard F Kochs, Karl-Ludwig Laugwitz, Bettina Jungwirth, Isabell Bernlochner
This study evaluates whether immature platelets (IPF) determined in the post anesthesia care unit (PACU) can predict major adverse cardiovascular events (MACE) or other thromboembolic events after intermediate and high-risk surgery. IPF are increased in patients with acute coronary syndrome and recently gained interest as novel biomarker for risk stratification. In this prospective observational trial 732 patients undergoing intermediate or high-risk non-cardiac surgery were enrolled (NCT02097602). IPF was measured preoperatively and postoperatively in the PACU...
August 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28795637/do-angptl-4-and-galectin-3-reflect-the-severity-of-coronary-artery-disease
#4
Luxitaa Goenka, Melvin George, Vishakha Singh, Amrita Jena, Deepika Seshadri, Vasanth Karunakaran, Dhandapani Vellala Elumalai, Jamuna Rani, Ilango Kaliappan
BACKGROUND: Coronary artery disease (CAD) is one of the leading causes of mortality and morbidity worldwide. We thereby sought to investigate whether the biomarkers, angiopoietin-like 4 (ANGPTL-4) and galectin-3, reflect the severity of CAD. METHODS: Patients were screened based on inclusion/exclusion criteria and written informed consent was obtained from the patients. Serum ANGPTL-4 and galectin-3 was quantified using enzyme-linked immunosorbent assay (ELISA) and correlated with the Global Registry of Acute Coronary Events (GRACE) and GENSINI score using Spearman's rank correlation coefficient and multivariate analysis...
August 1, 2017: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/28770211/prognostic-value-of-circulating-inflammatory-cells-in-patients-with-stable-and-acute-coronary-artery-disease
#5
REVIEW
John A L Meeuwsen, Marian Wesseling, Imo E Hoefer, Saskia C A de Jager
Atherosclerosis is a lipid driven chronic inflammatory disease underlying the majority of ischemic events such as myocardial infarction or stroke. Clinical management of ischemic events has improved considerably in the past decades. Accordingly, survival rates have increased. Nevertheless, 12% of patients die within 6 months after the initial event. To improve secondary prevention, appropriate risk prediction is key. However, up to date, there is no clinically available routine marker to identify patients at high risk for recurrent cardiovascular events...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28764841/non-st-elevation-acute-coronary-syndromes-a-comprehensive-review
#6
Tamunoinemi Bob-Manuel, Ikechuckwu Ifedili, Guy Reed, Uzoma N Ibebuogu, Rami N Khouzam
Non-ST elevation-acute coronary syndrome (NSTE-ACS) includes NSTE myocardial infarction and unstable angina. This patient population forms approximately two-thirds of all hospital admissions for ACS in the United States each year and is associated with an in-hospital mortality of 5%. NSTE-ACS is primarily due to an acute change in the supply and demand balance of coronary perfusion and myocardial oxygen consumption, because of the significant coronary artery obstruction presenting as plaque rupture or erosion...
September 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28752477/addition-of-biomarker-panel-improves-prediction-performance-of-american-college-of-surgeons-national-surgical-quality-improvement-program-acs-nsqip-calculator-for-cardiac-risk-assessment-of-elderly-patients-preparing-for-major-non-cardiac-surgery-a-pilot-study
#7
Danica Z Marković, Tatjana Jevtović-Stoimenov, Vladan Ćosić, Biljana Stošić, Bojana Marković Živković, Radmilo J Janković
BACKGROUND: Number of elderly patients subjected to extensive surgical procedures in the presence of cardiovascular morbidities is increasing every year. Therefore, there is a need to make preoperative diagnostics more accurate. AIMS: To evaluate the usefulness of American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator as a predictive tool in preoperative assessment of cardiovascular risk in elderly patients. METHODS: This prospective pilot study included 78 patients who were being prepared for extensive non-cardiac surgeries under general anaesthesia...
July 27, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28747015/nardilysin-is-a-promising-biomarker-for-the-early-diagnosis-of-acute-coronary-syndrome
#8
Po-Min Chen, Mikiko Ohno, Takaki Hiwasa, Kiyoto Nishi, Sayaka Saijo, Jiro Sakamoto, Yusuke Morita, Shintaro Matsuda, Shin Watanabe, Yasuhide Kuwabara, Koh Ono, Masao Imai, Katsumi Inoue, Tatsuya Murai, Tsukasa Inada, Masaru Tanaka, Toru Kita, Takeshi Kimura, Eiichiro Nishi
BACKGROUND: Biomarkers for detection of transient myocardial ischemia in patients with unstable angina (UA) or for very early diagnosis of acute myocardial infarction (AMI) are not currently available. METHODS AND RESULTS: We performed two sequential screenings of autoantibodies elevated shortly after the onset of acute coronary syndrome (ACS), and focused on metalloendopeptidase nardilysin (NRDC) among 19 identified candidate antigens. In a retrospective analysis among 93 ACS and 117 non-ACS patients, the serum level of NRDC was significantly increased in patients with ACS compared with that in patients with non-ACS (2073...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28742643/sensitive-troponin-i-and-stress-testing-in-the-emergency-department-for-the-early-management-of-chest-pain-using-2-hour-protocol
#9
Shahriar Dadkhah, Zakaria Almuwaqqat, Samian Sulaiman, Husein Husein, Quang Nguyen, Saad Ali, Tuncay Taskesen
BACKGROUND: Despite improvements in identifying high-risk patients with non-ST segment ACS (acute coronary syndrome), low risk patients presenting with atypical chest pain and non-diagnostic Electrocardiogram (ECG) continued to undergo unnecessary admissions and testing. Since 1992, our chest pain protocol included using 4-hour serial biomarkers from ED admission in combination with stress testing to evaluate these patients. Our study aimed at determining whether a new accelerated diagnostic protocol using sensitive cardiac troponin I (cTnI) 2 hours after admission to the ED followed by stress testing is safe and effective in emergency settings, allowing for appropriate triage, earlier discharge and reducing costs...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28728851/predictors-of-incident-heart-failure-in-patients-after-an-acute-coronary-syndrome-the-lipid-heart-failure-risk-prediction-model
#10
Andrea Driscoll, Elizabeth H Barnes, Stefan Blankenberg, David M Colquhoun, David Hunt, Paul J Nestel, Ralph A Stewart, Malcolm J West, Harvey D White, John Simes, Andrew Tonkin
BACKGROUND: Coronary heart disease is a major cause of heart failure. Availability of risk-prediction models that include both clinical parameters and biomarkers is limited. We aimed to develop such a model for prediction of incident heart failure. METHODS: A multivariable risk-factor model was developed for prediction of first occurrence of heart failure death or hospitalization. A simplified risk score was derived that enabled subjects to be grouped into categories of 5-year risk varying from <5% to >20%...
June 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28721152/clinical-syntax-score-a-good-predictor-for-renal-artery-stenosis-in-acute-myocardial-infarction-patients-analysis-from-the-ren-acs-trial
#11
Alexandru Burlacu, Dimitrie Siriopol, Ionut Nistor, Luminita Voroneanu, Igor Nedelciuc, Cristian Statescu, Adrian Covic
INTRODUCTION: In ST-elevation myocardial infarction (STEMI) patients, multisite artery disease represents a serious issue influencing evolution, outcomes and prognosis. We evaluated for the first time the power of the Myocardial Infarction SYNTAX Score (MI SS) and Clinical SYNTAX Score (MI CSS) as predictors for renal artery stenosis (RAS) in STEMI. We also stratified the study population according to the two scores, and identified the variables correlated with the higher score. MATERIAL AND METHODS: We used data from the REN-ACS study, which included 181 consecutive patients prospectively investigated for presence of RAS (through renal angiography), arterial stiffness (carotid-femoral pulse wave velocity, cf-PWV) and hydration status (bioimpedance)...
June 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28714336/specific-plasma-oxylipins-increase-the-odds-of-cardiovascular-and-cerebrovascular-events-in-patients-with-peripheral-artery-disease
#12
Stephanie P B Caligiuri, Harold M Aukema, Amir Ravandi, Renée Lavallée, Randy Guzman, Grant N Pierce
Oxylipins and fatty acids may be novel therapeutic targets for cardiovascular disease. The objective was to determine if plasma oxylipins or fatty acids can influence the odds of cardiovascular/cerebrovascular events. In 98 patients (25 female, 73 male) with peripheral artery disease, the prevalence of transient ischemic attacks, cerebrovascular accidents, stable angina, and acute coronary syndrome was n = 16, 10, 16, and 24, respectively. Risk factors such as being male, diagnosed hypertension, diabetes mellitus, and hyperlipidemia were not associated with events...
August 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28712187/utility-of-heart-type-fatty-acid-binding-protein-h-fabp-point-of-care-test-in-the-early-hours-of-stemi-compared-with-troponin-i-in-pakistani-population
#13
Walid Ahmad Abbasi, Muhammad Saleem, Shahid Rasheed, Azhar Mahmood Kiyani
BACKGROUND: Acute coronary syndrome remains a dominant cause of high morbidity and mortality despite advancements in treatment This study was conducted to examine the utility of point-of-care test of heart-type fatty-acid binding protein (h-FABP) and compare it with the point-of-care test of cardiac troponin I (cTnI) in the first 06 hours of STEMI. METHODS: This cross-sectional, comparative study which was conducted in Rawalpindi institute of cardiology, Rawalpindi, Pakistan, from January to June 2015...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28687265/contextualizing-myocardial-infarction-comorbidities-and-priorities-in-older-adults
#14
REVIEW
Ashok Krishnaswami, Mathew S Maurer, Karen P Alexander
Cardiovascular care for older adults has become increasingly complex due to a rise in the concurrent comorbidity burden that accompanies senescence. Internists, hospitalists, and cardiologists often encounter geriatric patients with multiple chronic conditions needing acute cardiovascular care. Abnormal cardiac biomarker levels in patients with multiple non-cardiac conditions are a common reason for older adults to enter the hospital. This type of acute coronary syndrome, defined as a non-ST segment elevation myocardial infarction or, more precisely, type 2 myocardial infarction, often leads to substantial consternation...
July 4, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28673240/association-of-platelet-to-lymphocyte-ratio-with-non-culprit-atherosclerotic-plaque-vulnerability-in-patients-with-acute-coronary-syndrome-an-optical-coherence-tomography-study
#15
Xuedong Wang, Zulong Xie, Xinxin Liu, Xingtao Huang, Jiale Lin, Dan Huang, Bo Yu, Jingbo Hou
BACKGROUND: The platelet to lymphocyte ratio (PLR), an indirect inflammatory biomarker, has been recently demonstrated to be associated with severity of coronary artery disease. In the present study, we sought to investigate whether PLR is associated with vulnerable plaque characteristics of non-culprit lesions in patients with acute coronary syndrome (ACS). METHODS: The patients in our study were divided into two groups (high PLR group and low PLR group). A total of 119 non-culprit plaques from 71 patients with ACS were assessed by optical coherence tomography (OCT)...
July 3, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28654911/radial-artery-intima-media-thickness-regresses-after-secondary-prevention-interventions-in-patients-post-acute-coronary-syndrome-and-is-associated-with-cardiac-and-kidney-biomarkers
#16
Damilola D Adingupu, Helena U Westergren, Santosh Dahgam, Ann-Cathrine Jönsson-Rylander, Juuso Blomster, Per Albertsson, Elmir Omerovic, Sara Svedlund, Li-Ming Gan
BACKGROUND: Radial artery intima-media thickness (rIMT) measured by ultra-high-resolution ultrasound is associated with increased cardiovascular risk and predicts outcomes. We performed non-invasive high-resolution ultrasound of the radial artery to investigate vascular changes in subjects presenting with acute coronary syndrome (ACS) and who had undergone percutaneous coronary intervention (PCI). PURPOSE: In the present work, we aimed to follow rIMT change over time post-acute coronary syndrome as a tool to monitor potential response to intensified medical therapy...
June 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28653131/novel-risk-stratification-assays-for-acute-coronary-syndrome
#17
REVIEW
Haitham M Ahmed, Stanley L Hazen
PURPOSE OF REVIEW: Since identification of aspartate aminotransferase as the first cardiac biomarker in the 1950s, there have been a number of new markers used for myocardial damage detection over the decades. There have also been several generations of troponin assays, each with progressively increasing sensitivity for troponin detection. Accordingly, the "standard of care" for myocardial damage detection continues to change. The purpose of this paper is to review the clinical utility, biological mechanisms, and predictive value of these various biomarkers in contemporary clinical studies...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28625369/rationale-and-design-of-the-hunting-for-the-off-target-properties-of-ticagrelor-on-endothelial-function-and-other-circulating-biomarkers-in-humans-hi-tech-trial
#18
RANDOMIZED CONTROLLED TRIAL
Sara Ariotti, Maarten van Leeuwen, Salvatore Brugaletta, Sergio Leonardi, Kristiaan Martijn Akkerhuis, Emrush Rexhaj, Gladys Janssens, Luis Ortega-Paz, Diego Rizzotti, Jan C van den Berge, Dierik Heg, Gloria Francolini, Stephan Windecker, Marco Valgimigli
BACKGROUND: Among the 3 approved oral P2Y12 inhibitors for the treatment for patients with acute coronary syndrome (ACS), ticagrelor, but not prasugrel or clopidogrel, has been associated with off-target properties, such as improved endothelial-dependent vasomotion and increased adenosine plasma levels. METHODS: The HI-TECH study (NCT02587260) is a multinational, randomized, open-label, crossover study with a Latin squares design, conducted at 5 European sites, in which patients free from recurrent ischemic or bleeding events ≥30 days after a qualifying ACS were allocated to sequentially receive a 30 ± 5-day treatment with prasugrel, clopidogrel, and ticagrelor in random order...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28624816/circulating-micrornas-as-potential-biomarkers-for-coronary-plaque-rupture
#19
Sufang Li, Chongyou Lee, Junxian Song, Changlin Lu, Jun Liu, Yuxia Cui, Huizhu Liang, Chengfu Cao, Feng Zhang, Hong Chen
Coronary plaque rupture is the most common cause of acute coronary syndrome. However, the timely biomarker-based diagnosis of plaque rupture remains a major unmet clinical challenge. Balloon dilatation and stent implantation during percutaneous coronary intervention (PCI) could cause plaque injury and rupture. Here we aimed to assess the possibility of circulating microRNAs (miRNAs) as biomarkers of acute coronary plaque rupture by virtue of the natural model of PCI-induced plaque rupture. Stable coronary artery disease patients underwent PCI with single stent implantation were recruited and a three-phase approach was conducted in the present study: (i) profiling of plasma miRNAs in a group of patients before (0 h) and after balloon dilatation for 1 h (1 h vs...
July 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28624396/hybrid-magnetic-resonance-imaging-and-positron-emission-tomography-with-fluorodeoxyglucose-to-diagnose-active-cardiac-sarcoidosis
#20
Marc R Dweck, Ronan Abgral, Maria Giovanna Trivieri, Philip M Robson, Nicolas Karakatsanis, Venkatesh Mani, Anna Palmisano, Marc A Miller, Anuradha Lala, Helena L Chang, Javier Sanz, Johanna Contreras, Jagat Narula, Valentin Fuster, Maria Padilla, Zahi A Fayad, Jason C Kovacic
OBJECTIVES: The purpose of this study was to explore the diagnostic usefulness of hybrid cardiac magnetic resonance (CMR) and positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) for active cardiac sarcoidosis. BACKGROUND: Active cardiac sarcoidosis (aCS) is underdiagnosed and has a high mortality. METHODS: Patients with clinical suspicion of aCS underwent hybrid CMR/PET with late gadolinium enhancement (LGE) and FDG to assess the pattern of injury and disease activity, respectively...
June 9, 2017: JACC. Cardiovascular Imaging
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