Markers of Plaque Instability in the Early Diagnosis and Risk Stratification of Acute Myocardial Infarction

Schaub, Nora; Reichlin, Tobias; Meune, Christophe; Twerenbold, Raphael; Haaf, Philip; Hochholzer, Willibald; Niederhauser, Nadine; Bosshard, Piet; Stelzig, Claudia; Freese, Michael; Reiter, Miriam; Gea, Joachim; Buser, Andreas; Mebazaa, Alexandre; Oßwald, Stefan; Mueller, Christian

doi:10.1373/clinchem.2011.172940

Cited by 58 publications

(46 citation statements)

References 42 publications

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“…Similar results were reported by other authors (11)(12)(13)(14)(15). Researches showed that there is a significant correlation between the CRP with an increased risk of cardiovascular death.…”

Section: Discussionsupporting

confidence: 91%

Troponin and C-reactive Protein in Risk Stratification after Myocardial Infarction

Hodžić¹,

Hasković²,

Duraković³

et al. 2017

Acta Facultatis Medicae Naissensis

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SU M M A RYThe aim of this study was to investigate the prognostic significance of troponin I, C-reactive protein and risk factors for the occurrence of complications after myocardial infarction.Troponin I and C-reactive protein values were analyzed in 38% of patients with complications (postinfarction angina, ventricular fibrillation, heart failure and fatal outcome) and in 62% of patients without complications. Values wererecorded on admission and between the eighth and tenth day of hospitalization.It was found that a larger number of risk factors (p = 0.00), diabetes mellitus (p = 0.02) and smoking (p = 0.01) were significantly associated with the complications. It was shown that hypertension increases the risk of developing heart failure after acute myocardial infarction (p = 0.02). It resulted with statistically non-significant difference in the observed values of troponin I between the group of patients with complications and the group without them (p = 0.22, p = 0.327).There was a statistically significant difference in the observed values of Creactive protein in the two groups of patients (p = 0.00, p = 0.01).It can be concluded that the values of troponin I had no prognostic significance in risk stratification, while the values of C-reactive protein, individual risk factors and a large numberof risk factors hadsignificance in risk stratification after myocardial infarction. Key words: myocardial infarction, troponin I, C-reactive protein, risk factors

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Section: Discussionsupporting

confidence: 91%

Troponin and C-reactive Protein in Risk Stratification after Myocardial Infarction

Hodžić¹,

Hasković²,

Duraković³

et al. 2017

Acta Facultatis Medicae Naissensis

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“…[14] was divided into two cohorts because they provided separated data for patients with ST-segment elevated myocardial infarction and non-ST-segment elevated ACS, respectively. Finally, 14 prospective studies (15 independent cohorts) concerning 12 830 participants and 1813 cases were included in our meta-analysis [9–17, 19–23]. Of the 15 cohorts, there were 7 endpoints of all-cause mortality [11, 12, 14–17, 23], 7 combinations of all-cause mortality and non-fatal MI [12–16, 20, 22], and 4 combinations of cardiac death, MI or revascularization [9, 10, 19, 21].…”

Section: Resultsmentioning

confidence: 99%

Systemic review/Meta-analysis Pregnancy-associated plasma protein A predicts adverse vascular events in patients with coronary heart disease: a systematic review and meta-analysis

Li¹,

Zhou²,

Zhou³

et al. 2013

aoms

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IntroductionProspective studies about the association between elevated circulating pregnancy-associated plasma protein A (PAPP-A) and adverse vascular events in patients with coronary heart diseases (CHD) are inconsistent. We performed a meta-analysis to clarify this issue.Material and methodsWe identified prospective studies by searching MEDLINE. The vascular outcomes included all-cause mortality, combination of all-cause mortality and non-fatal myocardial infarction (MI), and combined cardiovascular events. Prospective studies providing multivariable adjusted relative risks (RRs) and their 95% confidence intervals (CIs) of pre-mentioned outcomes were included. A random-effects model was used to calculate the pooled RRs. Subgroup and sensitivity analyses were used to explore the potential sources of heterogeneity or modifiable factors.ResultsFourteen studies with a total of 12 830 participants were included. Elevated PAPP-A level was associated with all-cause mortality (pooled RR 1.74, 95% CI: 1.45 to 2.09, p < 0.001), combined all-cause mortality and non-fatal MI (RR 1.59, 95% CI: 1.37 to 1.85, p < 0.001) and combined cardiovascular events (RR 1.50, 95% CI: 1.22 to 1.85, p < 0.001). There was no significant heterogeneity. Subgroup and sensitivity analyses showed that the positive association was not affected by follow-up term, CHD type, different assay methods of PAPP-A, or studies with less than 5 adjusted variables.ConclusionsElevated serum PAPP-A level is associated with adverse vascular outcomes in patients with CHD.

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“…Among ACS patients of the FAST-MI, authors found that low fetuin-A and high hs-CRP concentrations were associated with cardiovascular death, even after adjustment for GRACE risk score [132] . In another study by Schaub et al [133] in 398 consecutive patients presenting with acute chest pain novel biomarkers like myeloperoxidase, MRP-8/14 and hs-CRP, provided incremental value in the risk stratification of these patients.…”

Section: Modulation Of Inflammationmentioning

confidence: 99%

Adipose tissue and vascular inflammation in coronary artery disease

Golia¹,

Limongelli²,

Natale³

et al. 2014

WJC

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Obesity has become an important public health issue in Western and developing countries, with well known metabolic and cardiovascular complications. In the last decades, evidence have been growing about the active role of adipose tissue as an endocrine organ in determining these pathological consequences. As a consequence of the expansion of fat depots, in obese subjects, adipose tissue cells develope a phenotypic modification, which turns into a change of the secretory output. Adipocytokines produced by both adipocytes and adipose stromal cells are involved in the modulation of glucose and lipid handling, vascular biology and, moreover, participate to the systemic inflammatory response, which characterizes obesity and metabolic syndrome. This might represent an important pathophysiological link with atherosclerotic complications and cardiovascular events. A great number of adipocytokines have been described recently, linking inflammatory mileu and vascular pathology. The understanding of these pathways is crucial not only from a pathophysiological point of view, but also to a better cardiovascular disease risk stratification and to the identification of possible therapeutic targets. The aim of this paper is to review the role of Adipocytokines as a possible link between obesity and vascular disease. Key words: Adipocytokines; Obesity; Metabolic syndrome; Coronary artery disease; Inflammation Core tip: Our article, provide a comprehensive review of the evidence about adipose tissue and cardiovascular risk, focusing on the pathophysiological and clinical role of fat-derived mediators, the so-called adipocytokines.

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Markers of Plaque Instability in the Early Diagnosis and Risk Stratification of Acute Myocardial Infarction

Abstract: BACKGROUND:Plaque erosion and plaque rupture occur early in the pathophysiology of acute myocardial infarction (AMI). We hypothesized that markers of plaque instability might be useful in the early diagnosis and risk stratification of AMI.

Cited by 58 publications

References 42 publications

Troponin and C-reactive Protein in Risk Stratification after Myocardial Infarction

Troponin and C-reactive Protein in Risk Stratification after Myocardial Infarction

Systemic review/Meta-analysis Pregnancy-associated plasma protein A predicts adverse vascular events in patients with coronary heart disease: a systematic review and meta-analysis

Adipose tissue and vascular inflammation in coronary artery disease

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