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1.
Adv Exp Med Biol ; 1306: 41-59, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33959905

RESUMEN

Cardiac troponin T (cTnT) is a sensitive and specific biomarker for detecting cardiac muscle injury. Its concentration in blood can be significantly elevated outside the normal reference range under several pathophysiological conditions. The classical analytical method in routine clinical analysis to detect cTnT in serum or plasma is a single commercial immunoassay, which is designed to quantify the intact cTnT molecule. The targeted epitopes are located in the central region of the cTnT molecule. However, in blood cTnT exists in different biomolecular complexes and proteoforms: bound (to cardiac troponin subunits or to immunoglobulins) or unbound (as intact protein or as proteolytic proteoforms). While proteolysis is a principal posttranslational modification (PTM), other confirmed PTMs of the proteoforms include N-terminal initiator methionine removal, N-acetylation, O-phosphorylation, O-(N-acetyl)-glucosaminylation, N(ɛ)-(carboxymethyl)lysine modification and citrullination. The immunoassay probably detects several of those cTnT biomolecular complexes and proteoforms, as long as they have the centrally targeted epitopes in common. While analytical cTnT immunoreactivity has been studied predominantly in blood, it can also be detected in urine, although it is unclear in which proteoform cTnT immunoreactivity is present in urine. This review presents an overview of the current knowledge on the pathophysiological lifecycle of cTnT. It provides insight into the impact of PTMs, not only on the analytical immunoreactivity, but also on the excretion of cTnT in urine as one of the waste routes in that lifecycle. Accordingly, and after isolating the proteoforms from urine of patients suffering from proteinuria and acute myocardial infarction, the structures of some possible cTnT proteoforms are reconstructed using mass spectrometry and presented.


Asunto(s)
Infarto del Miocardio , Troponina T , Humanos , Fosforilación , Procesamiento Proteico-Postraduccional , Proteolisis , Troponina T/metabolismo
3.
Med J Aust ; 214(7): 310-317, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33792058

RESUMEN

OBJECTIVE: To determine whether the availability of invasive coronary angiography at the hospital of presentation influences catheterisation rates for patients with acute coronary syndrome (ACS), and whether presenting to a catheterisation-capable hospital is associated with better outcomes for patients with ACS. DESIGN, SETTING: Retrospective cohort study; analysis of Cooperative National Registry of Acute Coronary Events (CONCORDANCE) data. SETTING, PARTICIPANTS: Adults admitted with ACS to 43 Australian hospitals (including 31 catheterisation-capable hospitals), February 2009 - October 2018. MAIN OUTCOME MEASURES: Major adverse cardiovascular events (myocardial infarction, stroke, congestive heart failure, cardiogenic shock, cardiovascular death) and all-cause deaths in hospital and by six and 12- or 24-month follow-up. RESULTS: The proportion of women among the 5637 patients who presented to catheterisation-capable hospitals was smaller than for the 2608 patients who presented to hospitals without catheterisation facilities (28% v 33%); the proportion of patients diagnosed with ST elevation myocardial infarction was larger (32% v 20%). The proportions of patients who underwent catheterisation (81% v 70%) or percutaneous coronary intervention (49% v 35%) were larger for those who presented to catheterisation-capable hospitals. The baseline characteristics of patients who underwent catheterisation were similar for both presentation hospital categories, as were rates of major adverse cardiovascular events and all-cause death in hospital and by 6- and 12- or 24-month follow-up. CONCLUSIONS: Although a larger proportion of patients who presented to catheterisation-capable hospitals underwent catheterisation, patients with similar characteristics were selected for the procedure, independent of the hospital of presentation. Major outcomes for patients were also similar, suggesting equitable management of patients with ACS across Australia.


Asunto(s)
Síndrome Coronario Agudo/diagnóstico , Cateterismo Cardíaco/estadística & datos numéricos , Angiografía Coronaria/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Australia/epidemiología , Cateterismo Cardíaco/métodos , Angiografía Coronaria/métodos , Muerte , Femenino , Estudios de Seguimiento , Insuficiencia Cardíaca/epidemiología , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/epidemiología , Intervención Coronaria Percutánea/métodos , Intervención Coronaria Percutánea/estadística & datos numéricos , Estudios Retrospectivos , Infarto del Miocardio con Elevación del ST/diagnóstico , Infarto del Miocardio con Elevación del ST/epidemiología , Infarto del Miocardio con Elevación del ST/fisiopatología , Choque Cardiogénico/epidemiología , Accidente Cerebrovascular/epidemiología , Resultado del Tratamiento
4.
Int J Mol Sci ; 22(6)2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33808720

RESUMEN

Using a murine model of chronic ischemic cardiomyopathy caused by an old myocardial infarction (MI), we have previously found that three doses of 1 × 106 c-kit positive cardiac cells (CPCs) are more effective than a single dose of 1 × 106 cells. The goal of this study was to determine whether the beneficial effects of three doses of CPCs (1 × 106 cells each) can be fully replicated by a single combined dose of 3 × 106 CPCs. Mice underwent a 60-min coronary occlusion; after 90 days of reperfusion, they received three echo-guided intraventricular infusions at 5-week intervals: (1) vehicle × 3; (2) one combined dose of CPCs (3 × 106) and vehicle × 2; or (3) three doses of CPCs (1 × 106 each). In the combined-dose group, left ventricular ejection fraction (LVEF) improved after the 1st CPC infusion, but not after the 2nd and 3rd (vehicle) infusions. In contrast, in the multiple-dose group, LVEF increased after each CPC infusion; at the final echo, LVEF averaged 35.2 ± 0.6% (p < 0.001 vs. the vehicle group, 27.3 ± 0.2%). At the end of the study, the total cumulative change in EF from pretreatment values was numerically greater in the multiple-dose group (6.6 ± 0.6%) than in the combined-dose group (4.8 ± 0.8%), although the difference was not statistically significant (p = 0.08). Hemodynamic studies showed that several parameters of LV function in the multiple-dose group were numerically greater than in the combined-dose group (p = 0.08 for the difference in LVEF). Compared with vehicle, cardiomyocyte cross-sectional area was reduced only in the multiple-dose group (-32.7%, 182.6 ± 15.1 µm2 vs. 271.5 ± 27.2 µm2, p < 0.05, in the risk region and -28.5%, 148.5 ± 12.1 µm2 vs. 207.6 ± 20.5 µm2, p < 0.05, in the noninfarcted region). LV weight/body weight ratio and LV weight/tibia length ratios were significantly reduced in both cell treated groups vs. the vehicle group, indicating the attenuation of LV hypertrophy; however, the lung weight/body weight ratio was significantly reduced only in the multiple-dose group, suggesting decreased pulmonary congestion. Taken together, these results indicate that in mice with chronic ischemic cardiomyopathy, the beneficial effects of three doses of CPCs on LV function and hypertrophy cannot be fully replicated with a single dose, notwithstanding the fact that the total number of cells delivered with one or three doses is the same. Thus, it is the multiplicity of doses, and not the total number of cells, that accounts for the superiority of the repeated-dose paradigm. This study supports the idea that the efficacy of cell therapy in heart failure can be augmented by repeated administrations.


Asunto(s)
Cardiomiopatías/etiología , Dosificación de Gen , Isquemia Miocárdica/complicaciones , Miocitos Cardíacos/metabolismo , Proteínas Proto-Oncogénicas c-kit/genética , Animales , Biomarcadores , Biopsia , Pesos y Medidas Corporales , Cardiomiopatías/diagnóstico , Cardiomiopatías/metabolismo , Cardiomiopatías/terapia , Células Cultivadas , Modelos Animales de Enfermedad , Ecocardiografía , Fibrosis , Pruebas de Función Cardíaca , Hemodinámica , Hipertrofia Ventricular Izquierda/etiología , Hipertrofia Ventricular Izquierda/metabolismo , Hipertrofia Ventricular Izquierda/patología , Ratones , Infarto del Miocardio/etiología , Infarto del Miocardio/metabolismo , Infarto del Miocardio/patología , Isquemia Miocárdica/etiología , Proteínas Proto-Oncogénicas c-kit/metabolismo
5.
Medicine (Baltimore) ; 100(15): e25353, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847633

RESUMEN

BACKGROUND: To our knowledge, no meta-analyses or reviews have investigated the efficacy and safety of metformin on cardiovascular outcomes after acute myocardial infarction (AMI) in patients with type 2 diabetes mellitus (T2DM). We thus conduct a high-quality systematic review and meta-analysis to assess the efficacy and safety of metformin on cardiovascular outcomes after AMI in patients with T2DM. METHODS: In this systematic review and meta-analysis, we will search PUBMED, Scopus, EMBASE, and Cochrane Library databases through April, 2021. The study is structured to adhere to PRISMA guidelines (i.e., Preferred Reporting Items for Systematic Reviews and Meta-analyses). The literature search, data extraction, and quality assessments are conducted independently by 2 authors. Outcome measures include all-cause mortality; complications such as acute kidney injury, lactic acidosis, hospitalization for AMI or stroke, or death. Where disagreement in the collection of data occurs, this is resolved through discussion. Review Manager Software (v 5.3; Cochrane Collaboration) is used for the meta-analysis. Two independent reviewers will assess the risk of bias of the included studies at study level. RESULTS: It is hypothesized that metformin use at the post-AMI is associated with decreased risk of cardiovascular disease and death in patients with T2DM. CONCLUSIONS: This study expects to provide credible and scientific evidence for the efficacy and safety of metformin on cardiovascular outcomes after AMI in patients with T2DM. REGISTRATION NUMBER: 10.17605/OSF.IO/S3MBP.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/epidemiología , Hipoglucemiantes/uso terapéutico , Metformina/uso terapéutico , Infarto del Miocardio/epidemiología , Enfermedades Cardiovasculares/epidemiología , Ensayos Clínicos como Asunto , Hemoglobina A Glucada , Humanos , Hipoglucemiantes/administración & dosificación , Metformina/administración & dosificación , Infarto del Miocardio/mortalidad , Proyectos de Investigación
6.
Medicine (Baltimore) ; 100(15): e25404, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847638

RESUMEN

ABSTRACT: Previous studies have shown an independent association between increased red cell distribution width (RDW) and mortality after acute myocardial infarction (AMI). However, evidence regarding the predictive significance of repeated measures of RDW in patients with AMI remains scarce. We aimed to investigate the association between the dynamic profile of RDW and in-hospital mortality in patients with AMI.This was a cross-sectional study. We extracted clinical data from the Medical Information Mart for Intensive Care IIIV1.4 database. Demographic data, vital signs, laboratory test data, and comorbidities were collected from the database. The clinical endpoint was in-hospital mortality. Cox proportional hazards models were used to evaluate the prognostic values of basic RDW, and the Kaplan-Meier method was used to plot survival curves. Subgroup analyses were performed to measure mortality across various subgroups. The repeated-measures data were compared using a generalized additive mixed model.In total, 3101eligible patients were included. In multivariate analysis, adjusted for age, sex, and ethnicity, RDW was a significant risk predictor of in-hospital mortality. Furthermore, after adjusting for more confounding factors, RDW remained a significant predictor of in-hospital mortality (tertile 3 vs tertile 1: hazard ratio 2.3; 95% confidence interval 1.39-4.01; P for trend <.05). The Kaplan-Meier curve for tertiles of RDW indicated that survival rates were highest when RDW was ≤13.2% and lowest when RDW was ≥14.2% after adjustment for age, sex, and ethnicity. During the intensive care unit stay, the RDW of nonsurvivors progressively increased until death occurred.Our findings showed that a higher RDW was associated with an increased risk of in-hospital mortality in patients with AMI.


Asunto(s)
Índices de Eritrocitos , Eritrocitos/citología , Mortalidad Hospitalaria/tendencias , Infarto del Miocardio/mortalidad , Anciano , Comorbilidad , Estudios Transversales , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Factores Socioeconómicos
7.
Sensors (Basel) ; 21(5)2021 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-33803265

RESUMEN

Diverse computer-aided diagnosis systems based on convolutional neural networks were applied to automate the detection of myocardial infarction (MI) found in electrocardiogram (ECG) for early diagnosis and prevention. However, issues, particularly overfitting and underfitting, were not being taken into account. In other words, it is unclear whether the network structure is too simple or complex. Toward this end, the proposed models were developed by starting with the simplest structure: a multi-lead features-concatenate narrow network (N-Net) in which only two convolutional layers were included in each lead branch. Additionally, multi-scale features-concatenate networks (MSN-Net) were also implemented where larger features were being extracted through pooling the signals. The best structure was obtained via tuning both the number of filters in the convolutional layers and the number of inputting signal scales. As a result, the N-Net reached a 95.76% accuracy in the MI detection task, whereas the MSN-Net reached an accuracy of 61.82% in the MI locating task. Both networks give a higher average accuracy and a significant difference of p < 0.001 evaluated by the U test compared with the state-of-the-art. The models are also smaller in size thus are suitable to fit in wearable devices for offline monitoring. In conclusion, testing throughout the simple and complex network structure is indispensable. However, the way of dealing with the class imbalance problem and the quality of the extracted features are yet to be discussed.


Asunto(s)
Algoritmos , Infarto del Miocardio , Diagnóstico por Computador , Electrocardiografía , Humanos , Infarto del Miocardio/diagnóstico , Redes Neurales de la Computación
9.
Wiad Lek ; 74(3 cz 2): 625-629, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33843624

RESUMEN

OBJECTIVE: The aim: Is to determine the levels of markers of endothelial dysfunction in young men with myocardial infarction and their changes during the treatment with beta-blockers with different pharmacological properties. PATIENTS AND METHODS: Materials and methods: 112 male patients of Caucasian race of the Ukrainian population under the age of 50 with MI. Group I received Nebivolol, group II - bisoprolol. RESULTS: Results: During the 6-month follow-up, positive dynamics of NOS-2 and ET-1 was observed. The level of NOS-2 in groups I - II was 4272.3±162.7, 4629.7±161.2 pg/mL, respectively (p<0.05). The dynamics of ET-1 showed significant decrease of its level in all groups. CONCLUSION: Conclusions: Significant changes in markers of endothelial dysfunction, namely NOS3/eNOS, NOS2/iNOS and ET-1, are observed in young male patients of the Ukrainian population with MI. During 6 months of treatment, positive changes were observed in the form of an increase in NOS-3 levels and a significant decrease in ET-1 and NOS-2 levels. The inclusion of Nebivolol in the basic therapy for this group of patients is associated with an additional positive effect on the normalization of levels NO synthase and the reduction of ET-1.


Asunto(s)
Infarto del Miocardio , Antagonistas Adrenérgicos beta/uso terapéutico , Biomarcadores , Humanos , Masculino , Infarto del Miocardio/tratamiento farmacológico , Nebivolol/uso terapéutico , Óxido Nítrico
10.
Int J Mol Sci ; 22(6)2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33809145

RESUMEN

Acute myocardial infarction (MI) is one of the most common causes of death worldwide. Pituitary adenylate cyclase activating polypeptide (PACAP) is a cardioprotective neuropeptide expressing its receptors in the cardiovascular system. The aim of our study was to examine tissue PACAP-38 in a translational porcine MI model and plasma PACAP-38 levels in patients with ST-segment elevation myocardial infarction (STEMI). Significantly lower PACAP-38 levels were detected in the non-ischemic region of the left ventricle (LV) in MI heart compared to the ischemic region of MI-LV and also to the Sham-operated LV in porcine MI model. In STEMI patients, plasma PACAP-38 level was significantly higher before percutaneous coronary intervention (PCI) compared to controls, and decreased after PCI. Significant negative correlation was found between plasma PACAP-38 and troponin levels. Furthermore, a significant effect was revealed between plasma PACAP-38, hypertension and HbA1c levels. This was the first study showing significant changes in cardiac tissue PACAP levels in a porcine MI model and plasma PACAP levels in STEMI patients. These results suggest that PACAP, due to its cardioprotective effects, may play a regulatory role in MI and could be a potential biomarker or drug target in MI.


Asunto(s)
Arritmias Cardíacas/sangre , Infarto del Miocardio/sangre , Polipéptido Hipofisario Activador de la Adenilato-Ciclasa/sangre , Infarto del Miocardio con Elevación del ST/genética , Anciano , Animales , Arritmias Cardíacas/fisiopatología , Arritmias Cardíacas/cirugía , Femenino , Hemoglobina A Glucada/genética , Ventrículos Cardíacos/metabolismo , Ventrículos Cardíacos/patología , Ventrículos Cardíacos/cirugía , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/genética , Infarto del Miocardio/patología , Infarto del Miocardio/cirugía , Infarto del Miocardio sin Elevación del ST/sangre , Infarto del Miocardio sin Elevación del ST/genética , Infarto del Miocardio sin Elevación del ST/fisiopatología , Infarto del Miocardio sin Elevación del ST/cirugía , Intervención Coronaria Percutánea/efectos adversos , Polipéptido Hipofisario Activador de la Adenilato-Ciclasa/genética , Factores de Riesgo , Infarto del Miocardio con Elevación del ST/sangre , Infarto del Miocardio con Elevación del ST/patología , Infarto del Miocardio con Elevación del ST/cirugía , Porcinos , Resultado del Tratamiento , Troponina/sangre
11.
Int J Mol Sci ; 22(6)2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33809359

RESUMEN

In response to cardiac ischemia/reperfusion, proteolysis mediated by extracellular matrix metalloproteinase inducer (EMMPRIN) and its secreted ligand cyclophilin-A (CyPA) significantly contributes to cardiac injury and necrosis. Here, we aimed to investigate if, in addition to the effect on the funny current (I(f)), Ivabradine may also play a role against cardiac necrosis by reducing EMMPRIN/CyPA-mediated cardiac inflammation. In a porcine model of cardiac ischemia/reperfusion (IR), we found that administration of 0.3 mg/kg Ivabradine significantly improved cardiac function and reduced cardiac necrosis by day 7 after IR, detecting a significant increase in cardiac CyPA in the necrotic compared to the risk areas, which was inversely correlated with the levels of circulating CyPA detected in plasma samples from the same subjects. In testing whether Ivabradine may regulate the levels of CyPA, no changes in tissue CyPA were found in healthy pigs treated with 0.3 mg/kg Ivabradine, but interestingly, when analyzing the complex EMMPRIN/CyPA, rather high glycosylated EMMPRIN, which is required for EMMPRIN-mediated matrix metalloproteinase (MMP) activation and increased CyPA bonding to low-glycosylated forms of EMMPRIN were detected by day 7 after IR in pigs treated with Ivabradine. To study the mechanism by which Ivabradine may prevent secretion of CyPA, we first found that Ivabradine was time-dependent in inhibiting co-localization of CyPA with the granule exocytosis marker vesicle-associated membrane protein 1 (VAMP1). However, Ivabradine had no effect on mRNA expression nor in the proteasome and lysosome degradation of CyPA. In conclusion, our results point toward CyPA, its ligand EMMPRIN, and the complex CyPA/EMMPRIN as important targets of Ivabradine in cardiac protection against IR.


Asunto(s)
Basigina/genética , Ciclofilina A/genética , Infarto del Miocardio/tratamiento farmacológico , Proteína 1 de Membrana Asociada a Vesículas/genética , Animales , Biomarcadores/metabolismo , Cardiotónicos/farmacología , Modelos Animales de Enfermedad , Regulación de la Expresión Génica , Corazón/efectos de los fármacos , Corazón/fisiopatología , Humanos , Ivabradina/farmacología , Infarto del Miocardio/genética , Infarto del Miocardio/patología , Porcinos
12.
Medicine (Baltimore) ; 100(17): e25565, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33907105

RESUMEN

BACKGROUND: In order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the efficacy and safety of nicorandil prior to percutaneous coronary intervention in acute myocardial infarction (AMI) patients. METHODS: This systematic review and meta-analysis will be performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers independently will search randomized controlled trials or observational studies about the treatment of nicorandil on AMI patients. Retrieved databases include Web of Science, ClinicalTrials.gov, Pubmed, Embase, and Cochrane Library. And retrieval time is limited from inception to June 2021. Key words are nicorandil, myocardial infarction, or similar expansion words without publication limitation. Biomechanical studies, in vitro studies, review articles, techniques, case reports, letters to the editor, and editorials are excluded. RESULTS: The results of our review will be reported strictly following the PRISMA criteria and the review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/UEPKB.


Asunto(s)
Infarto del Miocardio/terapia , Nicorandil/administración & dosificación , Intervención Coronaria Percutánea , Cuidados Preoperatorios/métodos , Vasodilatadores/administración & dosificación , Enfermedad Aguda , Terapia Combinada , Humanos , Metaanálisis como Asunto , Estudios Observacionales como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
13.
Pan Afr Med J ; 38: 113, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33912283

RESUMEN

Coronary artery aneurysms are uncommon, are usually associated with atherosclerosis, and rarely involve all three major coronary arteries. Data on the optimal choice of acute myocardial infarction (AMI)´s revascularization in the context of polyarteritis nodosa (PAN) is limited to case reports and is still an open question. The present report describes a rare case of a young male patient followed for PAN presenting with acute myocardial infarction (AMI). Coronary angiography revealed multiple severe aneurysmal and stenotic changes. Based on clinical feature and angiographic findings, it was strongly suspected that the AMI was a complication of his vasculitis. This case indicates that coronary artery involvement should be carefully monitored during the chronic phase of PAN. The pathophysiology of AMI in PAN patients should be kept in mind and the interventional approach must be performed according to the angiographic findings to avoid complications.


Asunto(s)
Aneurisma Coronario/complicaciones , Muerte Súbita/etiología , Infarto del Miocardio/etiología , Poliarteritis Nudosa/complicaciones , Aneurisma Coronario/diagnóstico por imagen , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/fisiopatología , Poliarteritis Nudosa/diagnóstico por imagen
14.
Medicine (Baltimore) ; 100(14): e25429, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33832144

RESUMEN

BACKGROUND: There are no meta-analyses evaluating the efficacy and safety of colchicine in the treatment of acute myocardial infarction (AMI). Our protocol is conceived to evaluate the efficacy and safety of colchicine in comparison of placebo and test the hypothesis that a short course of treatment with colchicine could lead to reduced infarct size in patients presenting with AMI. METHODS: We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines and the recommendations of the Cochrane Collaboration to conduct this meta-analysis. Reviewers will search the PubMed, Cochrane Library, Web of Science, and EMBASE online databases for all English-language cohort studies published up to April, 2021. The cohort studies focusing on assess the efficacy and safety of colchicine in the treatment of AMI will be included in our meta-analysis. At least one of the following outcomes should have been measured: reduced infarct size, C-reactive protein (CRP) level, adverse events, death and major cardiovascular events. Review Manager software will be used for the meta-analysis. All outcomes are pooled on random-effect model. A P value of <.05 is considered to be statistically significant. RESULTS: Our protocol is conceived to evaluate the efficacy and safety of colchicine in comparison of placebo and test the hypothesis that a short course of treatment with colchicine could lead to reduced infarct size in patients presenting with AMI. REGISTRATION NUMBER: 10.17605/OSF.IO/NTU5F.


Asunto(s)
Antiinflamatorios/uso terapéutico , Colchicina/uso terapéutico , Infarto del Miocardio/tratamiento farmacológico , Protocolos Clínicos , Humanos , Modelos Estadísticos , Resultado del Tratamiento
15.
Hu Li Za Zhi ; 68(2): 32-42, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-33792017

RESUMEN

BACKGROUND: Prior to acute myocardial infarction (AMI), patients may experience different prodromal symptoms (PSs) that may delay their seeking medical treatment prior to hospitalization. PURPOSE: This study was designed to identify the relationship between PSs and demographics, including gender and age, acute symptoms, and pre-hospital delay time, in patients with AMI. METHODS: A cross-sectional study design was applied, and a convenience sampling approach was used to recruit 121 patients in the emergency room of a medical center located in southern Taiwan. Instruments, including a demographic and disease variables datasheet, acute symptoms of AMI, McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS), and pre-hospital delay time, were used. Chi-square, Fisher exact, and Spearman correlation coefficients tests were used to examine the respective relationships between the targeted variables and PSs. Binary logistic regression analysis was used to determine the important determinants of PSs. RESULTS: Most (83.5%) of the participants had experienced PSs. The MAPMISS score was significantly associated with age (ρ= -.20, p < .05) and marital status (Z = 2.23, p < .05). Three prodromal symptoms, including pain or discomfort in left breast, pain or discomfort in the legs, and change in headache intensity, were significantly different between male and female participants. Only one symptom, pain or discomfort in the central high chest area, differed significantly among age groups. Binary logistic regression analysis found that participants in the 40-60 years old age group were 3.19 times more likely to develop PSs than their peers in the 65 years old and older group. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results of this study suggest that PSs should be incorporated into medical education to increase the cognition and awareness of healthcare professionals toward PSs and to improve patient education overall in order to strengthen public awareness regarding the relationship between PSs and AMI and subsequently increase the timeliness of their seeking appropriate medical help.


Asunto(s)
Infarto del Miocardio , Síntomas Prodrómicos , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/complicaciones , Infarto del Miocardio/terapia , Factores de Riesgo , Taiwán
16.
Kardiologiia ; 61(3): 52-56, 2021 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-33849419

RESUMEN

Objective    To assess performance measures of attention of STEMI in Coronary Intensive Care Unit in General Hospital Camilo Cienfuegos.Methods    Admitted patients with STEMI, from February-April 2020, were compared with patients from similar period from 2015-2019, and patients from January 2019 to January 2020. Primary endpoint were performance measures according to the 2017 AHA / ACC Clinical Performance and Quality Measures for Adults with STEMI document, and secondary endpoint were all-cause in-hospital mortality and major acute coronary events.Results    Only 35 patients were admitted from February-April 2020. When comparing with similar periods from recent years, in-hospital death (8.3 % vs. 20 %; p=0.03), major complications (38.7 % vs. 57.1 %; p=0.03), and cardiogenic shock (6.9 % vs. 17.4 %; p=0.04) were significantly higher. When comparing with 2019 and January 2020, in-hospital death (9.6 %; p=0.04), and major complications (35.8 % p=0.03) were significantly higher in February-April 2020; however, there was no difference in prevalence of cardiogenic shock (8 %; p=0.12).Conclusion    COVID-19 pandemic had decreased prevalence of STEMI, as well as some performance measures of attention in this center.


Asunto(s)
Infarto del Miocardio , Intervención Coronaria Percutánea , Adulto , Mortalidad Hospitalaria , Humanos , Infarto del Miocardio/epidemiología , Pandemias
17.
Artículo en Inglés | MEDLINE | ID: mdl-33804153

RESUMEN

Hospital accreditation programs are used worldwide to improve the quality of care and improve patient safety. It is of great help in improving the structure of hospitals, but there are mixed research results on improving the clinical outcome of patients. The purpose of this study was to compare the levels of core clinical outcome indicators after receiving inpatient services from accredited and nonaccredited hospitals in patients with acute myocardial infarction (AMI). For all patients with AMI admitted to general hospitals in Korea from 2010 to 2017, their 30-day mortality and readmissions and length of stay were compared according to accreditation status. In addition, through a multivariate model that controls various patients' and hospitals' factors, the differences in those indicators were analyzed more accurately. The 30-day mortality of patients admitted to accredited hospitals was statistically significantly lower than that of patients admitted to nonaccredited hospitals. However, for 30-day readmission and length of stay, accreditation did not appear to yield more desirable results. This study shows that when evaluating the clinical impact of hospital accreditation programs, not only the mortality but also various clinical indicators need to be included, and a more comprehensive review is needed.


Asunto(s)
Pacientes Internos , Infarto del Miocardio , Acreditación , Hospitalización , Humanos , Infarto del Miocardio/terapia , República de Corea/epidemiología
18.
Medicine (Baltimore) ; 100(15): e25551, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847683

RESUMEN

BACKGROUND: The aim of the study was to evaluate the efficacy of nicorandil and alprostadil on myocardial protection in patients undergoing elective percutaneous coronary intervention (PCI). METHODS: In this prospective, single-blinded, randomized controlled study, 90 consecutive patients scheduled for elective PCI for de novo coronary lesions were assigned to the nicorandil, alprostadil, and nitroglycerin groups in a 1:1:1 ratio. Drugs were administered intracoronary via a targeted perfusion microcatheter. The primary endpoint was the thrombolysis in myocardial infarction (TIMI) myocardial perfusion frame count (TMPFC). Additionally, the corrected TIMI frame count (cTFC), TIMI myocardial perfusion grade (TMPG), and incidence of periprocedural myocardial injury (PMI) were assessed. RESULTS: Both nicorandil and alprostadil were significantly effective in reducing TMPFC (114.6 ±â€Š33.7 vs 93.4 ±â€Š30.9, P = .016; 114.3 ±â€Š34.3 vs 94.7 ±â€Š33.3, P = .029, respectively). Similar findings were observed in the improvement of cTFC (20.3 ±â€Š10.5 vs 13.5 ±â€Š5.0, P = .003; 20.2 ±â€Š7.4 vs 15.2 ±â€Š5.2, P = .003, respectively) and percentage of TMPG 3 (100% vs 82.8%, P = .052; 83.3% vs 96.7%, P = .196, respectively); whereas, nitroglycerin produced a limited effect on TMPFC (114.4 ±â€Š30.9 vs 112.1 ±â€Š31.9, P = .739), cTFC (19.4 ±â€Š7.2 vs 19.3 ±â€Š7.2, P = .936), and percentage of TMPG 3 (86.7% vs 86.7%, P = 1.000). No significant difference was found in the incidence of PMI (16.7% vs 16.0% vs 27.6%, P = .537), though it was comparatively lower in the nicorandil and alprostadil groups. Furthermore, the intracoronary administration of nicorandil and alprostadil had a mild effect on blood pressure and heart rate. CONCLUSIONS: The intracoronary administration of nicorandil and alprostadil via a targeted perfusion microcatheter was more effective in improving myocardial perfusion in patients undergoing elective PCI than nitroglycerin.


Asunto(s)
Alprostadil/administración & dosificación , Cardiotónicos/administración & dosificación , Infarto del Miocardio/terapia , Nicorandil/administración & dosificación , Nitroglicerina/administración & dosificación , Vasodilatadores/administración & dosificación , Anciano , Vías de Administración de Medicamentos , Procedimientos Quirúrgicos Electivos/métodos , Femenino , Corazón/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Intervención Coronaria Percutánea/métodos , Perfusión , Estudios Prospectivos , Método Simple Ciego , Resultado del Tratamiento
19.
Medicine (Baltimore) ; 100(15): e25553, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847684

RESUMEN

BACKGROUND: Acute myocardial infarction (AMI) is a common disease leading threat to human health around the world. Here we aimed to explore new biomarkers and potential therapeutic targets in AMI through adopting integrated bioinformatics tools. METHODS: The gene expression Omnibus (GEO) database was used to obtain genes data of AMI and no-AMI whole blood. Furthermore, differentially expressed genes (DEGs) were screened using the "Limma" package in R 3.6.1 software. Functional and pathway enrichment analyses of DEGs were performed via "Bioconductor" and "GOplot" package in R 3.6.1 software. In order to screen hub DEGs, the STRING version 11.0 database, Cytoscape and molecular complex detection (MCODE) were applied. Correlation among the hub DEGs was evaluated using Pearson's correlation analysis. RESULTS: By performing DEGs analysis, 289 upregulated and 62 downregulated DEGs were successfully identified from GSE66360, respectively. And they were mainly enriched in the terms of neutrophil activation, immune response, cytokine, nuclear factor kappa-B (NF-κB) signaling pathway, IL-17 signaling pathway, and tumor necrosis factor (TNF) signaling pathway. Based on the data of protein-protein interaction (PPI), the top 10 hub genes were ranked, including interleukin-8 (CXCL8), TNF, N-formyl peptide receptor 2 (FPR2), growth-regulated alpha protein (CXCL1), transcription factor AP-1 (JUN), interleukin-1 beta (IL1B), platelet basic protein (PPBP), matrix metalloproteinase-9 (MMP9), toll-like receptor 2 (TLR2), and high affinity immunoglobulin epsilon receptor subunit gamma (FCER1G). What's more, the results of correlation analysis demonstrated that there was positive correlation between the 10 hub DEGs. CONCLUSION: Ten DEGs were identified as potential candidate diagnostic biomarkers for patients with AMI in present study. However, further experiments are needed to confirm the functional pathways and hub genes associated with AMI.


Asunto(s)
Biología Computacional/métodos , Perfilación de la Expresión Génica/métodos , Infarto del Miocardio/genética , Biomarcadores/análisis , Correlación de Datos , Citocinas/metabolismo , Bases de Datos Genéticas , Humanos , Inmunidad/genética , Activación Neutrófila/genética , Mapas de Interacción de Proteínas/genética , Transducción de Señal/genética
20.
Int J Mol Sci ; 22(5)2021 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-33800220

RESUMEN

Cardiovascular disease is the leading cause of mortality and morbidity around the globe, creating a substantial socio-economic burden as a result. Myocardial infarction is a significant contributor to the detrimental impact of cardiovascular disease. The death of cardiomyocytes following myocardial infarction causes an immune response which leads to further destruction of tissue, and subsequently, results in the formation of non-contractile scar tissue. Macrophages have been recognized as important regulators and participants of inflammation and fibrosis following myocardial infarction. Macrophages are generally classified into two distinct groups, namely, classically activated, or M1 macrophages, and alternatively activated, or M2 macrophages. The phenotypic profile of cardiac macrophages, however, is much more diverse and should not be reduced to these two subsets. In this review, we describe the phenotypes and functions of macrophages which are present in the healthy, as well as the infarcted heart, and analyze them with respect to M1 and M2 polarization states. Furthermore, we discuss therapeutic strategies which utilize macrophage polarization towards an anti-inflammatory or reparative phenotype for the treatment of myocardial infarction.


Asunto(s)
Activación de Macrófagos , Macrófagos/inmunología , Infarto del Miocardio/inmunología , Miocardio/inmunología , Animales , Humanos , Macrófagos/patología , Infarto del Miocardio/patología , Miocardio/patología
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