Long-Term Prognostic Significance of High-Sensitive Troponin I Increase during Hospital Stay in Patients with Acute Myocardial Infarction and Non-Obstructive Coronary Arteries

Abstract

Background and Objectives: A topic already widely investigated is the negative prognostic value regarding the extent of high sensitive troponin I (hs-TnI) increases among patients with myocardial infarction (MI) and obstructive coronary atherosclerosis compared to a group of patients with MI and non-obstructive coronary atherosclerosis (MINOCA). Thus, the aim of this study was to evaluate the prognostic value concerning the extent of hs-TnI increase on clinical outcomes among patients with a MINOCA working diagnosis. Materials and Methods: We selected 337 consecutive patients admitted to hospital with a working diagnosis of MINOCA. The patients were divided in three groups according to the extent of hs-TnI increase during hospitalization (increase ≤5-times above the limit of the upper norm, >5 and ≤20-times, and >20-times). The study endpoints included all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE; cerebral stroke and transient ischemic attacks, MI, coronary artery revascularization, either percutaneous coronary intervention or coronary artery bypass grafting and all-cause mortality). Results: During the mean follow-up period of 516.1 ± 239.8 days, using Kaplan–Meier survival curve analysis, significantly higher mortality rates were demonstrated among patients from the group with the greatest hs-TnI increase compared to the remaining groups (p = 0.01) and borderline values for MACCE (p = 0.053). Multivariable cox regression analysis did not confirm hs-TnI among factors related to increased MACCE or all-cause mortality rates. Conclusion: While a relationship between clinical outcomes and the extent of the hs-TnI increase among patients with a MINOCA working diagnosis remains, it does not seem to be not as strong as it is in patients with obstructive coronary atherosclerosis.

The Significance of Systemic Immune-Inflammatory Index for Mortality Prediction in Diabetic Patients Treated with Off-Pump Coronary Artery Bypass Surgery

“…Different inflammatory parameters obtained from whole blood count were taken into consideration, presenting exclusively the systemic immune-inflammatory index (SII) as significant in T2DM patients, which is novel regarding previous reports [23,24]. Despite common assumptions in clinical practice, the significance of inflammatory reactions rather than the myocardial perioperative injury markers was confirmed to be prognostic for long-term survival in the analysis [25,26].…”

Coronary Artery Magnetic Resonance Angiography Combined with Computed Tomography Angiography in Diagnosis of Coronary Heart Disease by Reconstruction Algorithm

“…For the diagnosis of CHD, branches of coronary artery lesions can be intuitively found, which is of great significance for assessing the degree of branch obstruction and judging the severity of disease [ 8 , 9 ]. Image reconstruction technology plays an important role in many fields, and there are a series of extremely complex image processing and mathematical calculation problems in the research and implementation of the reconstruction algorithm [ 10 , 11 ]. The essence of back-projection reconstruction is to evenly erase (back projection) the ray projection taken from the finite object space onto all points in the infinite space where the ray reaches, including the point with the original pixel value of 0 [ 12 , 13 ].…”

ST-segment elevation myocardial infarction with non-obstructive coronary arteries: Score derivation for prediction based on a large national registry

“…This disease affects both the large epicardial arteries and coronary microcirculation. Illnesses mimicking MINOCA and not directly related to the coronary arteries include, among others, myocarditis, pericarditis, prothrombotic conditions and ailments, stroke, sepsis, pulmonary embolism, kidney and heart failure, as well as other heart and large vessel diseases, causing malfunction, such as tachyaarhythmia, heart valve defects (aortic stenosis), cardiomyopathy (including stress-cardiomypathy) or aortic diseases [ 5 , 6 ]. The prognosis of MINOCA patients is independent of revascularisation.…”