Troponin and Anti-Troponin Autoantibody Levels in Patients with Ventricular Noncompaction

Ventricular hypertrabeculation/noncompaction is a morphologic and functional anomaly of myocardium characterized by prominent trabeculae accompanied by deep recessus. Dilated cardiomyopathy with left ventricular failure is observed in these patients, while the cause or pathophysiologic nature of this complication is not known. Anti-troponin antibodies are formed against circulating cardiac troponins after an acute coronary event or conditions associated with chronic myocyte necrosis, such as dilated cardiomyopathy. In present study, we aimed to investigate cardiac troponins and anti troponin autoantibodies in ventricular noncompaction/hypertrabeculation patients with/without reduced ejection fraction. A total of 50 patients with ventricular noncompaction and 23 healthy volunteers were included in this study. Noncompaction/hypertrabeculation was diagnosed with two-dimensional echocardiography using appropriate criteria. Depending on ejection fraction, patients were grouped into noncompaction with preserved EF (LVEF >50%, n = 24) and noncompaction with reduced EF (LVEF <35%, n = 26) groups. Troponin I, troponin T, anti-troponin I IgM and anti-troponin T IgM were measured with sandwich immunoassay method using a commercially available kit. Patients with noncompaction had significantly higher troponin I (28.98 +/- 9.21 ng/ml in NCNE group and 28.11 +/- 10.42 ng/ml in NCLE group), troponin T (22.17 +/- 6.97 pg/ml in NCNE group and 22.78 +/- 7.76 pg/ml in NCLE group) and antitroponin I IgM (1.92 +/- 0.43 mu g/ml in NCNE group and 1.79 +/- 0.36 mu g/ml in NCLE group) levels compared to control group, while antitroponin T IgM and IgG were only elevated in patients with noncompaction and reduced EF (15.81 +/- 6.52 mu g/ml for IgM and 16.46 +/- 6.25 mu g/ml for IgG). Elevated cardiac troponins and anti-troponin I autoantibodies were observed in patients with noncompaction preceding the decline in systolic function and could indicate ongoing myocardial damage in these patients

Nowa metoda oceny prognostycznej chorych z ostrym zawałem serca z uniesieniem odcinka ST poddanych pierwotnej angioplastyce wieńcowej: połączenie skal Zwolle i Syntax

Background: The Zwolle score (Zs) is a validated risk score used to identify low-risk patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). The Syntax score (Ss) is an angiographic score that evaluates the complexity of coronary artery disease.Aim: We aimed to create a simple risk score by combining these two scores for risk stratification in patients with STEMI undergoing primary PCI.Methods: 299 consecutive STEMI patients (mean age 57.4 ± 11.7 years, 240 men) who underwent primary PCI were prospectively enrolled into the present study. The study population was divided into tertiles based on admission Zs and Ss. A high Zs (&gt; 3) and high Ss (&gt; 24) were defined as values in the third tertiles. A low Zs and low Ss were defined as values in the lower two tertiles. Patients were then classified into four groups: high Zs and high Ss (HZsHSs, n = 26), high Zs and low Ss (HZsLSs, n = 29), low Zs and high Ss (LZsHSs, n = 48), and low Zs and low Ss (LZsLSs, n = 196). In-hospital cardiacoutcomes were then recorded.Results: In-hospital cardiovascular mortality was higher in HZsHSs (50%) compared to the HZsLSs (27.5%), LZsHSs (0%), and LZsLSs (0.5%) groups. After adjustment for potentially confounding factors, HZsHSs (OR 77.6, 95% CI 6.69–113.1, p = 0.001), and HZsLSs (OR 28.9, 95% CI 2.77–56.2, p = 0.005) status, but not LZsHSs and LZsLSs status, remained independent predictors of in-hospital cardiovascular mortality.Conclusions: STEMI patients with HZsHSs represent the highest risk population for in-hospital cardiovascular mortality.Wstęp: Skala Zwolle (Zs) jest zweryfikowaną skalą ryzyka stosowaną do identyfikowania chorych z grupy małego ryzyka z ostrym zawałem serca z uniesieniem odcinka ST (STEMI) poddanych pierwotnej przezskórnej interwencji wieńcowej (PCI). Skala Syntax (Ss) stanowi angiograficzną skalę służącą do oceny złożoności choroby wieńcowej (CAD).Cel: Celem badania było stworzenie prostej skali oceny ryzyka przez połączenie dwóch skal w celu stratyfikacji ryzyka u chorych ze STEMI poddanych pierwotnej PCI.Metody: Do badania włączono w sposób prospektywny 299 kolejnych chorych ze STEMI (śr. wieku 57,4 ± 11,7; 240 mężczyzn) poddanych pierwotnej PCI. Badaną populację podzielono na tercyle w zależności od punktacji w skalach Zs i Ss przy przyjęciu do szpitala. Do górnego tercyla kwalifikowano osoby z wysoką punktacją Zs (&gt; 3) i Ss (&gt; 24). Niską punktację Zs i Ss definiowano jako dwa dolne tercyle wartości. Następnie chorych podzielono na cztery grupy: wysoka punktacja Zs i wysoka punktacja Ss (HZsHSs, n = 26); wysoka punktacja Zs i niska punktacja Ss (HZsLSs, n = 29); niska punktacja Zs i wysoka punktacja Ss (LZsHSs, n = 48); niska punktacja Zs i niska punktacja Ss (LZsLSs, n = 196). Zebrano dane dotyczące kardiologicznych punktów końcowych.Wyniki: Śmiertelność wewnątrzszpitalna z przyczyn sercowo-naczyniowych była wyższa w grupie HZsHSs (50%) niż w grupach HZsLSs (27,5%), LZsHSs (0%) i LZsLSs (0,5%). Po skorygowaniu względem możliwych czynników zakłócających przynależność do grup HZsHSs (OR 77,6; 95% CI 6,69–113,1; p = 0,001) i HZsLSs (OR 28,9; 95% CI 2,77–56,2; p = 0,005) nadal stanowiła niezależny czynnik predykcyjny wewnątrzszpitalnego zgonu sercowo-naczyniowego, natomiast przynależność do grup LZsHSs i LZsLSs nie miała takiego znaczenia prognostycznego.Wnioski: Pacjenci ze STEMI zakwalifikowani do grupy HZsHSs charakteryzują się najwiekszym ryzykiem zgonu wewnątrzszpitalnego z przyczyn sercowo-naczyniowych.

Long-term prognostic significance of pentraxin-3 in patients with acute myocardial infarction: 5-year prospective cohort study

Objective: A predictive role of serum Pentraxin 3 (PTX3) for short-term adverse cardiovascular events including mortality in acute myocardial infarction (AMI) was reported in recent studies. The aim of the study was to investigate long-term prognostic significance of serum PTX3 in an AMI with 5-year follow-up period in this study

Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction

Objectives Red cell distribution width (RDW), a measure of red blood cell size heterogeneity, was evaluated in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI)

Comparison of Cockcroft-Gault and Modification of Diet in Renal Disease Formulas as Predictors of Cardiovascular Outcomes in Patients With Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

We prospectively assessed the value of estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease (MDRD) and Cockcroft-Gault (C-G) equations in predicting inhospital adverse outcomes after primary coronary intervention for acute ST-segment elevation myocardial infarction. We classified 647 patients into 3 categories according to eGFR, 90 mL/min/1.73 m(2). The eGFRC-G classified 17 patients in the >90 mL/min/1.73 m(2) subgroup and 6 and 11 patients in the 60 to 90 and 90 mL/min/1.73 m(2) (P = .01 and P = .01, respectively); the eGFR(MDRD) was not predictive. Although the MDRD equation more accurately estimates GFR in certain populations, the CG formula may be a better predictor of adverse events

Assessment of Tenascin-C Levels in Ventricular Noncompaction/Hypertrabeculation Patients: A Cross-Sectional Study

PurposeVentricular noncompaction/hypertrabeculation (NC/HT) is a rare form of congenital cardiomyopathy. We aimed to investigate the presence of serum tenascin-C (TN-C) in adult patients with NC/HT and evaluate its value

The relationship between epicardial adipose tissue and ST-segment resolution in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

The relationship between epicardial adipose tissue (EAT) and coronary artery disease has been predominantly demonstrated in the last two decades. The aim of this study was to investigate the predictive value of EAT thickness on ST-segment resolution that reflects myocardial reperfusion in patients undergoing primary percutaneous coronary intervention (pPCI) for acute ST-segment elevation myocardial infarction (STEMI). The present study prospectively included 114 consecutive patients (mean age 54 +/- A 10 years, range 35-83, 15 women) with first acute STEMI who underwent successful pPCI. ST-segment resolution (Delta STR) < 70 % was accepted as ECG sign of no-reflow phenomenon. The EAT thickness was measured by two-dimensional echocardiography. EAT thickness was increased in patients with no-reflow (3.9 +/- A 1.7 vs. 5.4 +/- A 2, p = 0.001). EAT thickness was also found to be inversely correlated with Delta STR (r = -0.414, p = 0.001). Multivariate logistic regression analysis demonstrated that EAT thickness independently predicted no-reflow (OR 1.43, 95 % CI 1.13-1.82, p = 0.003). Receiver operating characteristic curve analysis demonstrated good diagnostic accuracy for EAT thickness in predicting no-reflow [area under curve (AUC) = 0.72, 95 % CI 0.63-0.82, p < 0.001]. In conclusion, increased EAT thickness may play an important role in the prediction of no-reflow in STEMI treated with pPCI

Wartość prognostyczna stężenia rezystyny w surowicy u chorych z ostrym zawałem serca

Background: Resistin is a novel adipokine that is suggested to be involved in inflammatory conditions and atherosclerosis.Aim: To investigate the prognostic importance of resistin in acute myocardial infarction (AMI) patients.Methods: Resistin levels were measured in a population of 132 patients with AMI, of whom 72 (54%) had a diagnosis of ST elevation myocardial infarction (STEMI), and 60 (46%) had non-ST elevation myocardial infarction (NSTEMI). Thirty-three consecutive subjects who were referred to elective coronary angiography due to chest pain evaluation with normal coronary angiograms served as controls. All patients were followed-up for the occurrence of major adverse cardiac events (MACE).Results: There was a significant increase in serum resistin levels in patients with AMI compared to controls (3.71 ± 4.20 vs. 2.00 ± 1.05, p = 0.001, respectively). However, serum resistin levels were similar in patients with STEMI and NSTEMI. (4.26 ± 5.11 vs. 3.06 ± 2.64, p = 0.49, respectively). The patients with MACE had significantly higher levels of serum resistin levels compared to either the AMI or the control group (6.35 ± 5.47, p = 0.005, respectively). Logistic regression analysis revealed that resistin, left ventricular ejection fraction, and coronary artery bypass graft were independent predictors of MACE in AMI patients (OR = 1.11, 95% CI 1.01–1.22, p = 0.03 and OR = 3.84, 95% CI 1.26–11.71, p = 0.018, respectively).Conclusions: Serum resistin level was increased in patients with AMI and constituted a risk factor for MACE in this group.Wstęp: Rezystyna jest nową adipokiną, która prawdopodobnie uczestniczy w procesach zapalnych i rozwoju miażdżycy.Cel: Celem niniejszego badania była ocena wartości prognostycznej rezystyny u chorych z ostrym zawałem serca (AMI).Metody: Zmierzono stężenia rezystyny w populacji złożonej ze 132 chorych z AMI, spośród których u 72 (54%) osób rozpoznano zawał serca z uniesieniem odcinka ST (STEMI), a u 60 (46%) — zawał serca bez uniesienia odcinka ST (NSTEMI). Grupę kontrolną stanowiło 33 kolejnych pacjentów skierowanych na angiografię wieńcową w trybie planowym z powodu bólu w klatce piersiowej, u których wykazano prawidłowy obraz tętnic wieńcowych. Wszystkich chorych obserwowano pod kątem wystąpienia poważnych niepożądanych zdarzeń sercowych (MACE).Wyniki: U pacjentów z AMI stwierdzono istotne zwiększenie stężenia rezystyny w surowicy w porównaniu z osobami z grupykontrolnej (odpowiednio 3,71 ± 4,20 vs. 2,00 ± 1,05; p = 0,001). Jednak u chorych ze STEMI i NSTEMI stężenia rezystyny były podobne (odpowiednio 4,26 ± 5,11 vs. 3,06 ± 2,64; p = 0,49). U pacjentów z MACE stężenia rezystyny w surowicy (6,35 ± 5,47; p = 0,005) były istotnie wyższe niż u chorych z AMI i osób z grupy kontrolnej. W analizie regresji logistycznej wykazano, że stężenie rezystyny, frakcja wyrzutowa lewej komory i pomostowanie aortalno-wieńcowe były niezależnymi czynnikami predykcyjnymi MACE u chorych z AMI (odpowiednio: OR = 1,11; 95% CI 1,01–1,22; p = 0,03 i OR = 3,84; 95% CI 1,26–11,71; p = 0,018).Wnioski: Stężenie rezystyny w surowicy było zwiększone u chorych z AMI i stanowiło czynnik ryzyka MACE w tej grupie chorych

Comparison of Cockcroft-Gault and Modification of Diet in Renal Disease Formulas as Predictors of Cardiovascular Outcomes in Patients With Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

We prospectively assessed the value of estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease (MDRD) and Cockcroft-Gault (C-G) equations in predicting inhospital adverse outcomes after primary coronary intervention for acute ST-segment elevation myocardial infarction. We classified 647 patients into 3 categories according to eGFR, 90 mL/min/1.73 m(2). The eGFRC-G classified 17 patients in the >90 mL/min/1.73 m(2) subgroup and 6 and 11 patients in the 60 to 90 and 90 mL/min/1.73 m(2) (P = .01 and P = .01, respectively); the eGFR(MDRD) was not predictive. Although the MDRD equation more accurately estimates GFR in certain populations, the CG formula may be a better predictor of adverse events