The incidence of acute myocardial infarction (AMI) has been increasing rapidly in recent years, seriously endangering human health. Cardiac biomarkers play critical roles in the diagnosis and prognosis of AMI. Troponin is a highly sensitive and specific biomarker for AMI diagnosis and can independently predict adverse cardiac events. Other biomarkers such as N-terminal B-type natriuretic peptide and C reactive protein are also valuable predictors of cardiovascular prognosis. Recently, several novel biomarkers have been identified for the diagnosis and risk assessment in patients with AMI. A multibiomarker approach can potentially enhance the diagnostic accuracy and provide more information for the early risk stratification of AMI. In this review, we will summarise the biomarkers discovered in recent years and focus on their diagnostic and prognostic value for patients with AMI.
Background It has been documented that circulating chemerin is associated with inflammation, metabolic syndrome, and coronary artery disease. The present study was aimed to evaluate the prognostic value of serum chemerin in patients with chronic heart failure. Methods and Results We included 834 patients with chronic heart failure in a prospective cohort study and investigated the association between serum chemerin and clinical outcomes using multivariate Cox regression analysis. Patients with higher chemerin levels tended to be older and women and were more likely to experience hypertension, diabetes mellitus, and hyperlipemia. Cox regression analysis showed that chemerin was a significant predictor of major adverse cardiac events (hazard ratio, 1.83; 95% CI, 1.31–2.96) after adjustment for conventional risk factors. Net reclassification and integrated discrimination improvements for major adverse cardiac events were markedly improved by addition of chemerin to the reference model. In addition, chemerin was an independent predictor of all‐cause mortality (hazard ratio, 1.67; 95% CI, 1.21–2.73) after multivariable adjustment. Furthermore, the Kaplan–Meier survival analysis revealed that chemerin was a prognostic indicator of major adverse cardiac events in patients with chronic heart failure and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) levels above and below the median. Conclusions Our study suggests that chemerin is a novel serum marker for predicting major adverse cardiac events in patients with chronic heart failure.
Background The involvement of vaspin (visceral adipose tissue–derived serpin) in the development of atherosclerotic cardiovascular diseases has been documented. This study was designed to explore the prognostic value of serum vaspin in patients with acute myocardial infarction ( AMI ). Methods and Results We included 1036 AMI patients in a cohort study and determined the association between serum vaspin and major adverse cardiac events ( MACE ) using Cox regression analysis. The receiver operating characteristic curve indicated that serum vaspin could significantly differentiate patients with MACE , and the optimal cutoff value was 0.62 ng/mL. The Kaplan–Meier survival curve showed that patients with lower vaspin levels had higher incidence of MACE . Multivariate Cox regression analysis revealed that low vaspin was an independent predictor of MACE (hazard ratio: 0.74; 95% CI , 0.48–0.96; P =0.029), together with age; previous histories of AMI , heart failure, hypertension, and diabetes mellitus; Killip class; revascularization; CRP (C‐reactive protein); and NT‐proBNP (N‐terminal pro–B‐type natriuretic peptide). Integrated discrimination and net reclassification improvements for MACE were significantly improved by addition of vaspin to the model of traditional risk factors. Moreover, low vaspin was a valuable predictor of heart failure hospitalization (hazard ratio: 0.58; 95% CI , 0.37–0.89; P =0.005) and recurrent AMI (hazard ratio: 0.72; 95% CI , 0.53–0.95; P =0.036) after adjustment for conventional cardiovascular risk factors. Conclusions Our study suggests that serum vaspin is a significant prognostic marker of MACE in AMI patients.
BackgroundHeart failure with preserved ejection fraction (HFpEF) has received widespread attention in recent years. There is currently a lack of valuable predictors for the prognosis of this disease. Here, we aimed to identify a non-invasive scoring system that can effectively predict 1-year rehospitalisation for patients with HFpEF.MethodsWe included 151 consecutive patients with HFpEF in a prospective cohort study and investigated the association between H2FPEF score and 1-year readmission for heart failure using multivariate Cox regression analysis.ResultsOur findings indicated that obesity, age >70 years, treatment with ≥2 antihypertensives, echocardiographic E/e’ ratio >9 and pulmonary artery pressure >35 mm Hg were independent predictors of 1-year readmission. Three models (support vector machine, decision tree in R and Cox regression analysis) proved that H2FPEF score could effectively predict 1-year readmission for patients with HFpEF (area under the curve, 0.910, 0.899 and 0.771, respectively; p<0.001).ConclusionOur study demonstrates that the H2FPEF score has excellent predictive value for 1-year rehospitalisation of patients with HFpEF.
It has been well documented that corin is a critical protease involved in the regulation of blood pressure and cardiac function. We performed a case-control study to determine whether serum corin is associated with the risk of chronic heart failure (CHF). We included 484 consecutive CHF patients and 484 control subjects to investigate the potential relationship between serum corin and CHF using logistic regression analysis. Compared with healthy controls, the CHF patients were more likely to have histories of hypertension and diabetes, and had higher levels of N-terminal pro-brain natriuretic peptide and lower levels of corin. The odds ratios of ischemic and non-ischemic HF were significantly reduced with the growing levels of serum corin after multivariate adjustment. Moreover, the decrease in serum corin levels seemed to be associated with the severity of CHF. In conclusion, our study suggested that serum corin levels were reduced in CHF patients and inversely correlated with the incidence of ischemic and non-ischemic HF.
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