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Elahimanesh M, Shokri N, Mahdinia E, Mohammadi P, Parvaz N, Najafi M. Differential gene expression patterns in ST-elevation Myocardial Infarction and Non-ST-elevation Myocardial Infarction. Sci Rep 2024; 14:3424. [PMID: 38341440 PMCID: PMC10858964 DOI: 10.1038/s41598-024-54086-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/08/2024] [Indexed: 02/12/2024] Open
Abstract
The ST-elevation Myocardial Infarction (STEMI) and Non-ST-elevation Myocardial Infarction (NSTEMI) might occur because of coronary artery stenosis. The gene biomarkers apply to the clinical diagnosis and therapeutic decisions in Myocardial Infarction. The aim of this study was to introduce, enrich and estimate timely the blood gene profiles based on the high-throughput data for the molecular distinction of STEMI and NSTEMI. The text mining data (50 genes) annotated with DisGeNET data (144 genes) were merged with the GEO gene expression data (5 datasets) using R software. Then, the STEMI and NSTEMI networks were primarily created using the STRING server, and improved using the Cytoscape software. The high-score genes were enriched using the KEGG signaling pathways and Gene Ontology (GO). Furthermore, the genes were categorized to determine the NSTEMI and STEMI gene profiles. The time cut-off points were identified statistically by monitoring the gene profiles up to 30 days after Myocardial Infarction (MI). The gene heatmaps were clearly created for the STEMI (high-fold genes 69, low-fold genes 45) and NSTEMI (high-fold genes 68, low-fold genes 36). The STEMI and NSTEMI networks suggested the high-score gene profiles. Furthermore, the gene enrichment suggested the different biological conditions for STEMI and NSTEMI. The time cut-off points for the NSTEMI (4 genes) and STEMI (13 genes) gene profiles were established up to three days after Myocardial Infarction. The study showed the different pathophysiologic conditions for STEMI and NSTEMI. Furthermore, the high-score gene profiles are suggested to measure up to 3 days after MI to distinguish the STEMI and NSTEMI.
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Affiliation(s)
- Mohammad Elahimanesh
- Clinical Biochemistry Department, Faculty of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Nafiseh Shokri
- Clinical Biochemistry Department, Faculty of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Elmira Mahdinia
- Clinical Biochemistry Department, Faculty of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Payam Mohammadi
- Clinical Biochemistry Department, Faculty of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Najmeh Parvaz
- Clinical Biochemistry Department, Faculty of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Najafi
- Clinical Biochemistry Department, Faculty of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Ying C, Liu CF, Guo DQ, Du ZR, Wei YJ. Predictive values of bilirubin for in-hospital adverse events in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention. Clinics (Sao Paulo) 2023; 78:100306. [PMID: 37949037 PMCID: PMC10661652 DOI: 10.1016/j.clinsp.2023.100306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023] Open
Abstract
PURPOSE To investigate the association between serum bilirubin levels and in-hospital Major Adverse Cardiac Events (MACE) in patients with ST-segment Elevation Myocardial Infarction (STEMI) undergoing primary Percutaneous Coronary Intervention (PCI). METHODS A total of 418 patients with STEMI who underwent primary PCI were enrolled from October 1st, 2021 to October 31st 2022. The average age of enrolled participants was 59.23 years, and 328 patients (78.50%) were male patients. Patients were divided into MACE (patients with angina pectoris after infarction, recurrent myocardial infarction, acute heart failure, cardiogenic shock, malignant arrhythmias, or death after primary PCI) (n = 98) and non-MACE (n = 320) groups. Univariate and multivariate logistic regression analyses were performed to estimate the association between different bilirubin levels including Total Bilirubin (TB), Direct Bilirubin (DB), Indirect Bilirubin (IDB), and risk of in-hospital MACE. The area under the Receiver Operating Characteristic (ROC) curve was used to determine the accuracy of bilirubin levels in predicting in-hospital MACE. RESULTS The incidence of MACE in STEMI patients increased from the lowest to the highest bilirubin tertiles. Multivariate logistic regression analysis showed that increased total bilirubin level was an independent predictor of in-hospital MACE in patients with STEMI (p for trend = 0.02). Compared to the first TB group, the ORs for risk of MACE were 1.58 (95% CI 0.77‒3.26) and 2.28 (95% CI 1.13‒4.59) in the second and third TB groups, respectively. The ROC curve analysis showed that the areas under the curve for TB, DB and IDB in predicting in-hospital MACE were 0.642 (95% CI 0.578‒0.705, p < 0.001), 0.676 (95% CI 0.614‒0.738, p < 0.001), and 0.619 (95% CI 0.554‒0.683, p < 0.001), respectively. CONCLUSIONS The current study showed that elevated TB, DB, and IDB levels are independent predictors of in-hospital MACE in patients with STEMI after primary PCI, and that DB has a better predictive value than TB and IDB.
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Affiliation(s)
- Chen Ying
- Clinical Medical College, Weifang Medical University, Weifang City, Shandong Province, China; Department of Cardiology, Linyi People's Hospital, Weifang Medical University, Linyi City, Shandong Province, China
| | - Cun-Fei Liu
- Department of Cardiology, Linyi People's Hospital, Weifang Medical University, Linyi City, Shandong Province, China
| | - De-Qun Guo
- Department of Cardiology, Linyi People's Hospital, Weifang Medical University, Linyi City, Shandong Province, China
| | - Zheng-Ren Du
- Department of Cardiology, Linyi People's Hospital, Weifang Medical University, Linyi City, Shandong Province, China
| | - Yan-Jin Wei
- Department of Cardiology, Linyi People's Hospital, Weifang Medical University, Linyi City, Shandong Province, China.
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Xu B, Chen K, Su W, Liu Y, Sheng Y, Ye T, Wu G, Zong G. Correlation Between GDF11 Serum Levels, Severity of Coronary Artery Lesions, and the Prognosis of Patients with ST-segment Elevation Myocardial Infarction. J Cardiovasc Transl Res 2023; 16:938-947. [PMID: 36749564 DOI: 10.1007/s12265-023-10358-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/23/2023] [Indexed: 02/08/2023]
Abstract
We aimed to explore the correlation among serum GDF11, the severity of coronary artery lesions, and the prognosis of patients with ST-segment elevation myocardial infarction (STEMI). A total of 367 patients were enrolled and divided into control (n = 172) and STEMI (n = 195) groups. Serum GDF11 (P < 0.001) was an independent predictor of STEMI and was negatively correlated with SYNTAX score (P < 0.05). ROC curve analysis showed that serum GDF11 could screen patients for major adverse cardiovascular events (MACEs). KM curve analysis showed that patients with lower concentration of GDF11 had a higher incidence of MACEs, and Cox proportional hazards regression analysis showed that the serum GDF11 (P < 0.001) was an independent predictor of MACEs. Serum GDF11 was negatively correlated with the severity of coronary lesions and was also an independent prognostic indicator of MACEs in patients with STEMI.
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Affiliation(s)
- Baida Xu
- Department of Cardiology, The 904Th Hospital of Joint Logistic Support Force of PLA, Wuxi, 214044, China
- Wuxi Clinical College of Anhui Medical University, Wuxi, China
| | - Ke Chen
- Wuxi Clinical College of Anhui Medical University, Wuxi, China
| | - Wentao Su
- Wuxi Clinical College of Anhui Medical University, Wuxi, China
| | - Yehong Liu
- Department of Cardiology, The 904Th Hospital of Joint Logistic Support Force of PLA, Wuxi, 214044, China
| | - Ying Sheng
- Department of Cardiology, The 904Th Hospital of Joint Logistic Support Force of PLA, Wuxi, 214044, China
| | - Ting Ye
- Department of Cardiology, The 904Th Hospital of Joint Logistic Support Force of PLA, Wuxi, 214044, China
| | - Gangyong Wu
- Department of Cardiology, The 904Th Hospital of Joint Logistic Support Force of PLA, Wuxi, 214044, China.
- Wuxi Clinical College of Anhui Medical University, Wuxi, China.
| | - Gangjun Zong
- Department of Cardiology, The 904Th Hospital of Joint Logistic Support Force of PLA, Wuxi, 214044, China.
- Wuxi Clinical College of Anhui Medical University, Wuxi, China.
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Shen S, Ye J, Wu X, Li X. Association of N-terminal pro-brain natriuretic peptide level with adverse outcomes in patients with acute myocardial infarction: A meta-analysis. Heart Lung 2021; 50:863-869. [PMID: 34340134 DOI: 10.1016/j.hrtlng.2021.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/19/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Studies evaluating the association of blood level of N-terminal pro-brain natriuretic peptide (NT-proBNP) with adverse prognosis have yielded conflicting results in patients with acute myocardial infarction (AMI). This meta-analysis sought to evaluate the prognostic value of blood level of NT-proBNP in patients with AMI. METHODS Two authors independently searched articles in PubMed and Embase databases up to June 13, 2021. Studies evaluating the association of baseline NT-proBNP level with all-cause mortality or major adverse cardiovascular events (MACEs, including death, new or worsening heart failure, recurrent myocardial infarction, revascularization, stroke, etc.) among AMI patients were selected. Multivariable-adjusted risk ratio (RR) with 95% confidence interval (CI) was pooled by the highest vs. lowest category of NT-proBNP level. RESULTS A total of 19 studies enrolling 12,158 AMI patients were identified. When compared highest with the lowest category of NT-proBNP level, the pooled RR was 5.28 (95% CI 2.87-9.73) for in-hospital/30-day death, 2.62 (95% CI 2.04-3.37) for follow-up all-cause mortality, and 2.50 (95% CI 1.91-3.28) for follow-up MACEs, respectively. Subgroup analysis further confirmed the value of NT-proBNP in predicting all-cause mortality and MACEs. CONCLUSIONS Elevated NT-proBNP level is independently associated with an increased risk of all-cause mortality and MACEs. Determination of blood NT-proBNP level can improve risk stratification of AMI patients.
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Affiliation(s)
- Shenghui Shen
- Department of Cardiology, Tongde Hospital of Zhejiang Province, Hangzhou City, Zhejiang Province, 310012, PR China
| | - Jianhua Ye
- Department of Cardiology, Tongde Hospital of Zhejiang Province, Hangzhou City, Zhejiang Province, 310012, PR China
| | - Xiangzhong Wu
- Department of Intensive Medicine, Tongde Hospital of Zhejiang Province, Hangzhou City, Zhejiang Province, 310012, PR China
| | - Xiaoling Li
- Department of Cardiology, Tongde Hospital of Zhejiang Province, Hangzhou City, Zhejiang Province, 310012, PR China.
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Yao ME, Su MY, Huang Y, Chen W. Physiologically increased total bilirubin is associated with reduced risk of first myocardial infarction: A meta-analysis and dose-response analysis. Nutr Metab Cardiovasc Dis 2021; 31:1016-1026. [PMID: 33612380 DOI: 10.1016/j.numecd.2021.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 01/10/2023]
Abstract
AIM Bilirubin has potential predictive and prognostic value for myocardial infarction (MI), but the clinical evidence remains controversial. We performed this meta-analysis to systematically quantify the relationships between circulating bilirubin levels and the incidence of MI and post-MI adverse events. DATA SYNTHESIS We searched the PubMed, Cochrane Library, Embase, and Web of Science databases for ad-hoc studies, published up to October 17, 2020, recording bilirubin before MI (predictive analyses) or adverse events (prognostic analyses). Relative risks (RR) were pooled by a random-effects model. The dose-response analysis was conducted by restricted cubic splines. In patients without previous MI, increased total bilirubin (TB) reduced the risk of long-term (>3 year) first MI by 22% (95% confidence interval [CI]: 0.69-0.88, n = 4). The dose-response analysis indicated that the RR for first MI decreased by 2.7% per each 2 μmol/L increment of TB (three studies, 95% CI: 1.3%-4.1%, P < 0.001), with a cut-off value of 12.60 μmol/L for RR > 1.00. Elevated bilirubin reduced the incidence of first and recurrent MI by 36% (95% CI: 0.42-0.98, n = 7). However, after suffering MI, higher TB concentrations could not decrease the risk of recurrent MI (RR: 1.02, 95% CI: 0.67-1.55, n = 5) and increased the incidence of short-term (<1 year) post-MI major adverse cardiovascular events, all-cause mortality, and cardiovascular mortality, but not long-term (≥1 year). CONCLUSION Higher TB levels within a physiological range reduced the incidence of long-term first MI, with a cut-off value of 12.60 μmol/L.
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Affiliation(s)
- Miao-En Yao
- Longhua Hospital Shanghai University of Traditional Chinese Medicine, NO.725, South Wanping Road, Xuhui District, Shanghai, 200032, China; Shanghai University of Traditional Chinese Medicine, 1200 Cai Lun Road, Zhangjiang Hi-TechPark, Pudong New Area, Shanghai, 201203, China
| | - Mei-Yi Su
- Second Clinical College of Guangzhou University of Chinese Medicine, NO.232, Outer-ring East Road, Guangzhou Higher Education Mega Center, Panyu District, Guangzhou, 510006, China; Department of Cardiovascular Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, NO.111, Dade Road, Yue-Xiu District, Guangzhou, 510120, China
| | - Yi Huang
- Longhua Hospital Shanghai University of Traditional Chinese Medicine, NO.725, South Wanping Road, Xuhui District, Shanghai, 200032, China; Shanghai University of Traditional Chinese Medicine, 1200 Cai Lun Road, Zhangjiang Hi-TechPark, Pudong New Area, Shanghai, 201203, China
| | - Wei Chen
- Department of Critical Care Medicine, Longhua Hospital Shanghai University of Traditional Chinese Medicine, NO.725, South Wanping Road, Xuhui District, Shanghai, 200032, China.
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Petyunina OV, Kopytsya MP, Berezin AE, Skrynnyk OV. Subclinical emotional distress predicts 6-month clinical outcomes after ST-segment elevation myocardial infarction. Future Cardiol 2020; 16:457-467. [PMID: 32508125 DOI: 10.2217/fca-2019-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To investigate associations between subclinical distress and 6-month clinical outcomes after ST-segment elevation myocardial infarction (STEMI). Materials & methods: The case-control study involved 144 STEMI patients (72 STEMI having subclinical emotional disturbances were included to the case group and 72 STEMI individuals matched with age, sex and cardiovascular risk factors were enrolled to the control group). The primary end point was the combination of 6-month events including CV death, recurrent angina, newly diagnosed heart failure and re-hospitalization. Results: The emotional distress predicted out-hospital combined end point (odds ratio [OR] = 2.48; 95% CI: 1.12-5.33; p = 0.034). Other independent predictors of out-hospital end point were Type 2 diabetes mellitus (OR = 1.10; 95% CI: 1.02-1.23; p = 0.048), thrombolysis in myocardial infarction score <6 units (OR = 0.86; 95% CI: 0.67-0.92; p = 0.001) and the number of culprit vessels (OR = 1.19; 95% CI: 1.02-1.34; p = 0.002). Conclusion: Premorbid emotional distress independently predicted 6 month combined clinical end point in STEMI patients.
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Affiliation(s)
- Olga V Petyunina
- Senior researcher of department of prevention & treatment of emergency conditions, "LT Malaya Therapy National Institute NAMSU", 2A Liubovi Maloy av., Kharkiv 61039, Ukraine
| | - Mykola P Kopytsya
- Chief of Department of prevention & treatment of emergency conditions, "LT Malaya Therapy National Institute NAMSU", 2A Liubovi Maloy av., Kharkiv 61039, Ukraine
| | - Alexander E Berezin
- Senior Consultant of Therapeutic Unit, Internal Medicine Department, State Medical University of Zaporozhye, 26, Mayakovsky av., Zaporozhye UA-69035, Ukraine
| | - Olga V Skrynnyk
- Senior Staff of the Department of Clinical, Social & Child Psychiatry of the State Institution "Institute of Neurology, Psychiatry & Narcology of The National Academy of Medical Sciences of Ukraine", Assistant of The Department of Clinical Neurology, Psychiatry & Narcology of V. N. Karazin's Kharkiv National University, Kharkiv, Ukraine
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7
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Li L, Yang D, Li J, Niu L, Chen Y, Zhao X, Oduro PK, Wei C, Xu Z, Wang Q, Li Y. Investigation of cardiovascular protective effect of Shenmai injection by network pharmacology and pharmacological evaluation. BMC Complement Med Ther 2020; 20:112. [PMID: 32293408 PMCID: PMC7158159 DOI: 10.1186/s12906-020-02905-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/26/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Shenmai injection (SMI) has been used in the treatment of cardiovascular disease (CVD), such as heart failure, myocardial ischemia and coronary heart disease. It has been found to have efficacy on doxorubicin (DOX)-induced cardiomyopathy. The aims of this study were to explore the underlying molecular mechanisms of SMI treatment on CVD by using network pharmacology and its protective effect on DOX-induced cardiotoxicity by in vitro and in vivo experiment based on network pharmacology prediction. METHODS Network pharmacology method was used to reveal the relationship between ingredient-target-disease and function-pathway of SMI on the treatment of CVD. Chemical ingredients of SMI were collected form TCMSP, BATMAN-TCM and HIT Database. Drugbank, DisGeNET and OMIM Database were used to obtain potential targets for CVD. Networks were visualized utilizing Cytoscape software, and the enrichment analysis was performed using IPA system. Finally, cardioprotective effects and predictive mechanism confirmation of SMI were investigated in H9c2 rat cardiomyocytes and DOX-injured C57BL/6 mice. RESULTS An ingredient-target-disease & function-pathway network demonstrated that 28 ingredients derived from SMI modulated 132 common targets shared by SMI and CVD. The analysis of diseases & functions, top pathways and upstream regulators indicated that the cardioprotective effects of SMI might be associated with 28 potential ingredients, which regulated the 132 targets in cardiovascular disease through regulation of G protein-coupled receptor signaling. In DOX-injured H9c2 cardiomyocytes, SMI increased cardiomyocytes viability, prevented cell apoptosis and increased PI3K and p-Akt expression. This protective effect was markedly weakened by PI3K inhibitor LY294002. In DOX-treated mice, SMI treatment improved cardiac function, including enhancement of ejection fraction and fractional shortening. CONCLUSIONS Collectively, the protective effects of SMI on DOX-induced cardiotoxicity are possibly related to the activation of the PI3K/Akt pathway, as the downstream of G protein-coupled receptor signaling pathway.
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Affiliation(s)
- Lin Li
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Dongli Yang
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Jinghao Li
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Lu Niu
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Ye Chen
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Xin Zhao
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Patrick Kwabena Oduro
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Chun Wei
- Tianjin Medical University Cancer Hospital, Tianjin, 300060, China
| | - Zongpei Xu
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Qilong Wang
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
| | - Yuhong Li
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
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Tuxun M, Zhao Q, Xiang Y, Liu F, Shan CF, Zhou XR, Song N, Waisiding A, Zhang XH, Aihemaiti G, Yang YN, Li XM. Predicting value of white cell count and total bilirubin on clinical outcomes in patients with ST-elevation myocardial infarction following percutaneous coronary intervention: a cohort study. BMJ Open 2020; 10:e031227. [PMID: 32075822 PMCID: PMC7044918 DOI: 10.1136/bmjopen-2019-031227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES A combined equation based on white cell count (WCC) and total bilirubin (TB) was assessed for its ability to predict adverse clinical outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) with primary percutaneous coronary intervention (PCI). DESIGN A single-centre, prospective cohort study. SETTING The First Affiliated Hospital of Xinjiang Medical University. METHOD A total of 615 patients with STEMI postprimary PCI were enrolled. WCC and TB were collected at admission. Logistic regression was used to determine the combined equation. The primary endpoints were in-hospital mortality and major adverse cardiovascular events (MACE), which composed of cardiac death, cardiac shock, malignant arrhythmia (ventricular tachycardia, ventricular fibrillation), severe cardiac insufficiency, non-fatal myocardial infarction, angina pectoris readmission, severe cardiac insufficiency (cardiac III-IV level), stent restenosis and target vessels revascularisation during the hospitalisation and 36 months follow-up period. RESULT 77 patients occurred in MACE during the hospitalisation (17 in-hospital mortality). WCC and TB were taken as an independent variables to make a category of logistic regression analysis of in-hospital MACE, the logistic regression model was: logit (P)=-8.00+0.265 WCC+0.077 TB, the combination of WCC and TB was more valuable on evaluating the in-hospital mortality (area under the curve 0.804, 95% CI 0.678 to 0.929, p<0.001). Multivariate logistic regression analysis showed that combined detection was an independent risk factor for in-hospital MACE (OR 5.85, 95% CI 3.425 to 9.990, p=0.032). During the follow-up period, 172 patients (29.5%) developed MACE. But the combined detection did not predict the long-term clinical outcome. CONCLUSION The combination of WCC and TB is an independent predictor for in-hospital outcomes in patients with STEMI than single detection.
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Affiliation(s)
- Munire Tuxun
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Qian Zhao
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asian, Urumqi, China
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Clinical Medical Research Institute of First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yang Xiang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Fen Liu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asian, Urumqi, China
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Clinical Medical Research Institute of First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Chun-Fang Shan
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xin-Rong Zhou
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asian, Urumqi, China
| | - Ning Song
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ajiguli Waisiding
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xue-He Zhang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Gulandanmu Aihemaiti
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yi-Ning Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asian, Urumqi, China
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Clinical Medical Research Institute of First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiao-Mei Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asian, Urumqi, China
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Clinical Medical Research Institute of First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Gao F, Qiang H, Fan XJ, Xue Q, Bai L. Higher serum total bilirubin predicts high risk of 3-year adverse outcomes in patients undergoing primary percutaneous coronary intervention. Ther Clin Risk Manag 2019; 15:811-821. [PMID: 31308679 PMCID: PMC6612951 DOI: 10.2147/tcrm.s203433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 05/08/2019] [Indexed: 12/22/2022] Open
Abstract
Purpose: Previous research findings on the association between serum total bilirubin (TB) and cardiovascular events varied with different study populations. Our objective was to clarify the association between serum TB at admission and long-term adverse outcomes in patients with acute coronary syndrome (ACS) and stable angina (SA) undergoing percutaneous coronary intervention (PCI). Patients and methods: This prospective cohort study included 2,502 patients who underwent PCI. Information on the study population was obtained from the Dryad Digital Repository. The patients were divided into two groups: high (>0.60 mg/dL) and low TB groups (≤0.60 mg/dL) based on the optimal cutoff value achieved in the receiver operating characteristic curve analysis. The relationships between serum TB at admission and clinical outcomes after PCI were analyzed in multivariable logistic regression models and restricted cubic spline. Results: In all patients undergoing PCI, TB>0.60 mg/dL was associated with major adverse cardiovascular events (MACE) and cardiovascular death during a 3-year follow-up. The odds ratio (95% confidence interval) was 1.60 (1.22–2.10) and 1.81 (1.22–2.70) for MACE and cardiovascular death, respectively. The association between TB and MACE was not altered by clinical presentation (p for interaction=0.949). Conclusion: In patients with ACS and SA undergoing PCI, elevated serum TB was associated with increased risk of MACE and cardiovascular death.
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Affiliation(s)
- Fan Gao
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Hua Qiang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xiao-Juan Fan
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Qi Xue
- Institut des Sciences de la Terre, Centre National de la Recherche Scientifique, Saint-Martin-d'Hères, France
| | - Ling Bai
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
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Prognostic Value of Serum Total Bilirubin after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5243589. [PMID: 31275974 PMCID: PMC6558622 DOI: 10.1155/2019/5243589] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 05/19/2019] [Indexed: 01/06/2023]
Abstract
Backgrounds Previous studies have reported a relationship between serum total bilirubin (STB) and coronary artery disease (CAD). However, the relationship between STB and prognosis of patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) remains inconclusive. The present study aimed to evaluate the relationship between STB level and prognosis of PCI in patients with ACS. Methods In total, 2850 ACS patients who underwent PCI at the Affiliated Zhongda Hospital of Southeast University from June 2009 to Jan 2017 were included in the study. Twenty-four-hour STB, 30-day, and 1-year postoperative major adverse cardiovascular events (MACE) were recorded. Subjects were assigned to one of three groups based on STB: Group A (STB ≤ 9.6 μmol/L), Group B (9.7 μmol/L < STB ≤ 15.4 μmol/L), and Group C (STB ≥ 15.5 μmol/L). COX survival analysis was subsequently used to investigate the relationship between the incidence of MACE and STB in the three groups. Results A total of 2770 subjects were successfully followed up; within 1 year after PCI, 115 (4.15%) subjects died and 191 (6.90%) subjects experienced MACE. One-year follow-up results showed that the incidence of MACE decreased significantly as STB increased; the risk of Group A was 2.002 times that of Group C (95% CI: 1.342-2.986). Cardiac mortality also decreased with increasing STB; the risk of Group A was 3.403 times that of Group C (95% CI: 1.319-8.785). Conclusion Lower mortality and MACE incidence rates were found in patients with higher STB within 1 year. Therefore, STB is highly recommended as an independent long-term prognosis predictor of PCI in patients with ACS.
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11
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Shen H, Zeng C, Wu X, Liu S, Chen X. Prognostic value of total bilirubin in patients with acute myocardial infarction: A meta-analysis. Medicine (Baltimore) 2019; 98:e13920. [PMID: 30653097 PMCID: PMC6370131 DOI: 10.1097/md.0000000000013920] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Experimental data obtained in animal models supported the protective role of bilirubin. However, clinical studies regarding the prognostic role of total bilirubin in patients with acute myocardial infarction (AMI) are conflicting. We, therefore, undertook this meta-analysis to evaluate the prognostic value of serum total bilirubin in AMI patients. METHODS Relevant studies were searched from PubMed and EMBASE databases up to April 15, 2018. Studies evaluating the outcomes in relation to serum total bilirubin in AMI patients and reporting multivariable-adjusted risk estimate of the prognostic value were eligible. The outcome measures were major adverse cardiac events (MACEs), cardiovascular death, and all-cause mortality. RESULTS Six studies involving 14,554 AMI patients were identified. Meta-analysis indicated that higher total bilirubin was associated with an increased risk of MACEs (risk ratio [RR] 1.65; 95% confidence intervals [CI] 1.25-2.19) and cardiovascular death (RR 2.12; 95%CI 1.24-3.64). However, higher serum total bilirubin did not significantly increase all-cause mortality risk (RR 1.31; 95%CI 0.75-2.28). Subgroup analyses by the types of AMI and study design supported the pooled results. CONCLUSIONS Higher serum total bilirubin level is a predictor of MACEs and cardiovascular death in patients with AMI. However, interpretation of these findings should be with caution due to the impact of cardiac dysfunction after AMI.
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12
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Fan Y, Zou C. Prognostic value of neutrophil gelatinase-associated lipocalin in patients with acute ST-segment elevation myocardial infarction: A meta-analysis. Eur J Prev Cardiol 2018; 26:444-446. [PMID: 29916725 DOI: 10.1177/2047487318783254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Yu Fan
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, China
| | - Chen Zou
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, China
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13
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Wang YP, Wang JH, Wang XL, Liu JY, Jiang FY, Huang XL, Hang JY, Qin W, Ma SX, Zhang J, Yuan MJ, Li JB, Lu ZG, Wei M. Roles of ST2, IL-33 and BNP in predicting major adverse cardiovascular events in acute myocardial infarction after percutaneous coronary intervention. J Cell Mol Med 2017. [PMID: 28623858 PMCID: PMC5661109 DOI: 10.1111/jcmm.13183] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study investigated roles of serum ST2, IL-33 and BNP in predicting major adverse cardiovascular events (MACEs) in acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Blood samples were collected from the included AMI patients (n = 180) who underwent PCI. All patients were divided into the MACEs and MACEs-free groups. Enzyme-linked immunosorbent assay was performed to measure serum levels of ST2, IL-33 and BNP. Severity of coronary artery lesion was evaluated by Gensini score. Pearson correlation analysis was used. A receiver operating characteristics curve was drawn to evaluate the potential roles of ST2, IL-33 and BNP in predicting MACEs, and Kaplan-Meier curve to analyse the 1-year overall survival rate. Logistic regression analysis was conducted to analyse the independent risk factors for MACEs. Compared with the MACEs-free group, the serum levels of ST2, IL-33 and BNP were significantly higher in the MACEs group. Serum levels of ST2, IL-33 and BNP were positively correlated with each other and positively correlated with Gensini score. The area under curves of ST2, IL-33 and BNP, respectively, were 0.872, 0.675 and 0.902. The relative sensitivity and specificity were, respectively, 76.27% and 85.92%, 69.49% and 58.68%, as well as, 96.61% and 77.69%. Serum levels of ST2, IL-33 and BNP were independent risk factors for MACEs. The 1-year overall survival rate was higher in AMI patients with lower serum levels of ST2, IL-33 and BNP. In conclusion, serum levels of ST2, IL-33 and BNP have potential value in predicting MACEs in AMI patients undergoing PCI.
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Affiliation(s)
- Yan-Peng Wang
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jian-Hua Wang
- Clinical Laboratory, Fu Yang People's Hospital, Anhui, China
| | - Xiao-Long Wang
- Department of Cardiology, Hong Si Bao People's Hospital, Wuzhong, Ningxia Hui Autonomous Region, China
| | - Jun-Yi Liu
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Fang-Yun Jiang
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xiao-Li Huang
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jing-Yu Hang
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wei Qin
- Shanghai Runda Rongjia Biological Company Ltd., Shanghai, China
| | - Shi-Xin Ma
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jie Zhang
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Min-Jie Yuan
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jing-Bo Li
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Zhi-Gang Lu
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Meng Wei
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Reinstadler SJ, Feistritzer HJ, Reindl M, Klug G, Mayr A, Mair J, Jaschke W, Metzler B. Combined biomarker testing for the prediction of left ventricular remodelling in ST-elevation myocardial infarction. Open Heart 2016; 3:e000485. [PMID: 27738517 PMCID: PMC5030543 DOI: 10.1136/openhrt-2016-000485] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 08/10/2016] [Accepted: 08/22/2016] [Indexed: 12/14/2022] Open
Abstract
Objective The utility of different biomarkers for the prediction of left ventricular remodelling (LVR) following ST-elevation myocardial infarction (STEMI) has been evaluated in several studies. However, very few data exist on the prognostic value of combined biomarkers. The aim of this study was to comprehensively investigate the prognostic value for LVR of routinely available biomarkers measured after reperfused STEMI. Methods Serial measurements of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and high-sensitivity C reactive protein (hs-CRP) were performed in 123 patients with STEMI treated with primary percutaneous coronary intervention in this prospective observational study. Patients underwent cardiac MRI at 2 (1–4) and 125 (121–146) days after infarction. An increase in end-diastolic volume of ≥20% was defined as LVR. Results LVR occurred in 16 (13%) patients. Peak concentrations of the following biomarkers showed significant areas under the curves (AUCs) for the prediction of LVR—NT-proBNP: 0.68 (95% CI 0.59 to 0.76, p=0.03), hs-cTnT: 0.75 (95% CI 0.66 to 0.82, p<0.01), AST: 0.72 (95% CI 0.63 to 0.79, p<0.01), ALT: 0.66 (95% CI 0.57 to 0.75, p=0.03), LDH: 0.78 (95% CI 0.70 to 0.85, p<0.01) and hs-CRP: 0.63 (95% CI 0.54 to 0.72, p=0.05). The combination of all biomarkers yielded a significant increase in AUC to 0.85 (95% CI 0.77 to 0.91) (all vs NT-proBNP: p=0.02, all vs hs-cTnT: p=0.02, all vs AST: p<0.01, all vs ALT: p<0.01, all vs hs-CRP: p<0.01 and all vs LDH: p=0.04). Conclusions In patients with reperfused STEMI, the combined assessment of peak NT-proBNP, hs-cTnT, AST, ALT, hs-CRP and LDH provide incremental prognostic information for the prediction of LVR when compared with single-biomarker measurement.
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Affiliation(s)
- Sebastian Johannes Reinstadler
- Department of Cardiology and Angiology , University Clinic of Internal Medicine III, Medical University of Innsbruck , Innsbruck , Austria
| | - Hans-Josef Feistritzer
- Department of Cardiology and Angiology , University Clinic of Internal Medicine III, Medical University of Innsbruck , Innsbruck , Austria
| | - Martin Reindl
- Department of Cardiology and Angiology , University Clinic of Internal Medicine III, Medical University of Innsbruck , Innsbruck , Austria
| | - Gert Klug
- Department of Cardiology and Angiology , University Clinic of Internal Medicine III, Medical University of Innsbruck , Innsbruck , Austria
| | - Agnes Mayr
- Department of Radiology , Medical University of Innsbruck , Innsbruck , Austria
| | - Johannes Mair
- Department of Cardiology and Angiology , University Clinic of Internal Medicine III, Medical University of Innsbruck , Innsbruck , Austria
| | - Werner Jaschke
- Department of Radiology , Medical University of Innsbruck , Innsbruck , Austria
| | - Bernhard Metzler
- Department of Cardiology and Angiology , University Clinic of Internal Medicine III, Medical University of Innsbruck , Innsbruck , Austria
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Kim HW, Choi DH, Lim L, Lee YM, Kang JT, Chae SS, Ki YJ, Song H, Koh YY. Usefulness of serum bilirubin levels as a biomarker for long-term clinical outcomes after percutaneous coronary intervention. Heart Vessels 2014; 30:728-33. [DOI: 10.1007/s00380-014-0546-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 06/27/2014] [Indexed: 12/16/2022]
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