Immunomarkers in Acute Coronary Syndrome Upon Admission  and Its Transition to Myocardial Infarction

Алиева, Маржанат Г.

doi:10.18470/1992-1098-2017-4-211-218

Ûg Ross.: èkol. razvit.

2017

DOI: 10.18470/1992-1098-2017-4-211-218

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Immunomarkers in Acute Coronary Syndrome Upon Admission and Its Transition to Myocardial Infarction

Маржанат Г. Алиева¹

Abstract: Резюме. Цель. Изучение и разработка прогностических критериев клинического исхода острого коронарного синдрома в инфаркт миокарда на основании иммуномаркеров. Материалы и методы исследования. Представлены результаты обследования 85 пациентов, поступивших в инфарктное отделение Республикан-ской клинической больницы Центра специализированной экстренной медицинской помощи (ЦСЭМП) г. Ма-хачкалы. Иммуномаркеры определяли методом ИФА и методом непрямой иммунофлуоресценции. Резуль-таты. Из исследованных маркеров кард… Show more

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Comparative assessment of short-term prognosis in patients with ST-segment elevation acute coronary syndrome without percutaneous coronary intervention based on the GRACE, TIMI, RECORD, PREDICT scales

Alnaser

Сычев

Pushkina

et al. 2022

Cardiovasc Ther Prev

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Aim. To conduct a comparative assessment of the short-term prognosis in patients with ST-segment elevation acute coronary syndrome (STE-ACS) without percutaneous coronary intervention (PCI) based on the Global Registry of Acute Cardiac Events (GRACE), Thrombolysis In Myocardial Infarction (TIMI), RECORD, PREdicting risk of Death In Cardiac disease Tool (PREDICT) scales and to ident ify the most significant markers of fatal and non-fatal complications.Material and methods. Eighty-two STE-ACS patients without PCI were examined. Risk assessment was carried out using the GRACE, TIMI, RECORD, and PREDICT scales. Outcomes were assessed 30 days after markers. To assess the predictive value of above scales, sensitivity (Se) and specificity (Sp), as well as relative risk with a 95% confidence interval, were calculated.Results. Comparative analysis of the prognosis of developing fatal complications in STE-ACS patients without PCI revealed the following predictive characteristics of scales: GRAСE — Se=1,000, Sp=0,54, χ2=25,763 (p<0,001); PREDICT — Se=0,281, Sp=0,96, χ2=20,297 (p<0,001); TIMI — Se=0,75, Sp=0,94, χ2=51,985 (p<0,001); RECORD — Se=1,000, Sp=0,48, χ2=21,716 (p<0,001). Regarding the development of non-fatal complications, the following data was obtained: GRACE — Se=0,680, Sp=0,760, χ2=9,970 (p<0,01); PREDICT — Se=0,080, Sp=1,000, χ2=4,167 (р>0,05); TIMI — Se=0,120, Sp=1,000, χ2=8,171 (р<0,05); RECORD — Se=0,680, Sp=0,640, χ2=5,128 (р<0,05). The most significant criteria for developing fatal and non-fatal complications were identified as follows: Killip class II acute heart failure, systolic blood pressure <100 mm Hg, age >65 years, stage ≥II A chronic heart failure, ST elevation ≥1 mm at admission, ejection fraction ≤<40%.Conclusion. A comparative evaluation of the 30-day prognostic significance of short-term scales (GRACE, RECORD, TIMI, PREDICT) in STE-ACS patients without PCI showed an ambiguous prognosis for developing both fatal and non-fatal complications. High sensitivity rates for predicting fatal complications were revealed in the GRACE and RECORD scales (100 and 100%, respectively) relative to the TIMI and PREDICT (75 and 28,1%, respectively), as well as for non-fatal complications in the GRACE and RECORD (68% for both) scales relative to the TIMI and PREDICT (12 and 8%, respectively).

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Comparative assessment of short-term prognosis in patients with ST-segment elevation acute coronary syndrome without percutaneous coronary intervention based on the GRACE, TIMI, RECORD, PREDICT scales

Alnaser

Сычев

Pushkina

et al. 2022

Cardiovasc Ther Prev

View full text Add to dashboard Cite

show abstract

Acute coronary syndrome in patients with cancer: features of the course and the possibility of predicting hospital and long-term (6 months) periods using GDF-15, NT-proBNP, hs-CRP biomarkers

Шаленкова¹,

Иванов²,

Климкин³

2021

Kardiologiia

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Aim To evaluate clinical features of the course of acute coronary syndrome (ACS) in patients with oncological diseases (OD) and to determine the role of biomarkers GDF-15, NT-proBNP, and hs-CRP in short-term and long-term prognoses.Material and methods In 88 patients (34 patients with ACS and OD and 54 patients with ACS without OD), complaints and historical, objective, and laboratory and instrumental data were evaluated and blood concentrations of GDF-15, NT-proBNP, and hs-CRP biomarkers were measured on the first day of hospitalization. Incidence of cardiovascular complications (CVC) and outcomes of hospital and long-term (6 months) periods were analyzed. Statistical analysis of results was performed with the Statistica 12.0, MedCalc 19.1.7 software. The level of statistical significance was р<0.05.Results In the ACS+OD group as compared to the ACS without OD group, the onset of disease was mostly atypical, with shortness of breath and/or general weakness; the ACS+OD patients more frequently had III-IV Killip class acute heart failure (29 and 7 %, р=0.01); mean hemoglobin concentration (125.6±27.9 and 141±16.6 g/l, р=0.003), prothrombin index (76.4±15.2 and 84.9±17.6 %, р=0.003), and left ventricular ejection fraction (47.7±6.1 and 50.7±7.2 %, р=0.02) were lower; and median concentrations of GDF-15 (1.95 [1.3; 2.8] and 1.45 [1.2; 2.0] ng/ml, р=0.03), NT-proBNP (947.3 [517.8; 1598.2], and 491.1 [85.1; 1069.1] pg/ml, р=0.006), and hs-CRP (14.1 [8.15; 36.75] and 7.8 [4.4; 16.2] mg/l, р=0.01) were higher. The presence of OD was associated with development of CVC, including urgent endpoints in the long-term and also increased the probability of fatal outcome within 6 months after discharge from the hospital. To predict the risk of CVC in patients with ACS and OD, two models with high prognostic values (AUC>0.9) were proposed. In the long-term, the value of NT-proBNP (cut-off point >524.5 pg/ml) was a statistically significant predictor for development of endpoints with a high predictive value (AUC>0.8).Conclusion The features of the clinical course of ACS in patients with OD indicate the importance of isolating such patients into a separate group. Additional use of the developed models, along with a standard risk assessment by the GRACE scale, will allow individualized management of patients with ACS and OD during the hospital and long-term (6 months) periods.

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Immunomarkers in Acute Coronary Syndrome Upon Admission and Its Transition to Myocardial Infarction

Cited by 2 publications

References 1 publication

Comparative assessment of short-term prognosis in patients with ST-segment elevation acute coronary syndrome without percutaneous coronary intervention based on the GRACE, TIMI, RECORD, PREDICT scales

Comparative assessment of short-term prognosis in patients with ST-segment elevation acute coronary syndrome without percutaneous coronary intervention based on the GRACE, TIMI, RECORD, PREDICT scales

Acute coronary syndrome in patients with cancer: features of the course and the possibility of predicting hospital and long-term (6 months) periods using GDF-15, NT-proBNP, hs-CRP biomarkers

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