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Han L, Zhang L, Hu W, Lu Y, Wang Z. Association of C-reactive protein with all-cause and cause-specific mortality in people with gout. Eur J Med Res 2024; 29:320. [PMID: 38858782 PMCID: PMC11163753 DOI: 10.1186/s40001-024-01923-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024] Open
Abstract
AIMS To test the association of C-reactive protein (CRP) with all-cause and cause-specific mortality in people with gout. METHODS This cohort study included 502 participants with gout from the National Health and Nutrition Examination Survey. Multivariate Cox regression analysis, subgroup analysis, and restricted cubic spline (RCS) analyses were utilized to examine the association of CRP levels with all-cause, cardiovascular, and cancer mortality. RESULTS After adjusting for multiple variables, Cox regression analysis showed that compared with individuals in the lowest tertile of CRP levels, those in the middle and highest tertiles experienced increases in all-cause mortality risk of 74.2% and 149.7%, respectively. Similarly, the cancer mortality risk for individuals in the highest tertile of CRP levels increased by 283.9%. In addition, for each standard deviation increase in CRP, the risks of all-cause and cancer mortality increased by 25.9% and 35.4%, respectively (P < 0.05). Subgroup analyses demonstrated that the association between CRP levels and all-cause mortality remained significant across subgroups of age (≤ 60 and > 60 years), gender (male), presence or absence of hypertension, non-diabetes, cardiovascular disease, non-cardiovascular disease and non-cancer. Furthermore, the association with cancer mortality was significant in subgroups including males, those without hypertension and cancer, and those with or without diabetes. However, the association with cardiovascular mortality was only significant in the non-hypertension subgroup (P < 0.05). Nonlinear association of CRP with all-cause mortality and linear association with cancer mortality were also confirmed (P for nonlinearity = 0.008 and 0.135, respectively). CONCLUSIONS CRP levels were associated with increased all-cause and cancer mortality among individuals with gout.
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Affiliation(s)
- Lishuai Han
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Lijuan Zhang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Wenlu Hu
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yang Lu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Zhenwei Wang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
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Guo L, Lv H, Wang J, Zhang B, Zhu Y, Zhang X, Zhu H, Zhou X, Xia Y. Predictive value of high sensitivity C-reactive protein in three-vessel disease patients with and without type 2 diabetes. Cardiovasc Diabetol 2023; 22:91. [PMID: 37081535 PMCID: PMC10120230 DOI: 10.1186/s12933-023-01830-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/08/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) and atherosclerosis are multifactorial conditions and share a common inflammatory basis. Three-vessel disease (TVD) represents a major challenge for coronary intervention. Nonetheless, the predictive value of high-sensitivity C-reactive protein (hs-CRP) for TVD patients with or without type 2 DM remains unknown. Herein, we aimed to ascertain the long-term predictive value of hs-CRP in TVD patients according to type 2 DM status from a large cohort. METHODS A total of 2734 TVD patients with (n = 1040, 38%) and without (n = 1694, 62%) type 2 diabetes were stratified based on the hs-CRP (< 2 mg/L vs. ≥ 2 mg/L). Three multivariable analysis models were performed to evaluate the effect of potential confounders on the relationship between hs-CRP level and clinical outcomes. The Concordance index, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to assess the added effect of hs-CRP and the baseline model with established risk factors on the discrimination of clinical outcomes. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE). RESULTS The median follow-up duration was 2.4 years. Multivariate Cox regression analyses showed that the incidence of MACCE (adjusted hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.01-1.35, p = 0.031) and all-cause death (HR 1.82, 95% CI 1.07-3.11, p = 0.026) were significantly higher in the diabetic group compared to the non-diabetic group. In the diabetic group, the incidence of MACCE (adjusted HR 1.51, 95% CI 1.09-2.10, p = 0.013) was significantly higher in the high hs-CRP group than in the low hs-CRP group; no significant difference was found for all-cause death (HR 1.63; 95% CI 0.58-4.58, p = 0.349). In the non-diabetic group, the prevalence of MACCE (adjusted HR 0.93, 95% CI 0.71-1.22, p = 0.613) was comparable between the two groups. Finally, the NRI (0.2074, p = 0.001) and IDI (0.0086, p = 0.003) for MACCE were also significantly increased after hs-CRP was added to the baseline model in the diabetic group. CONCLUSIONS Elevated hs-CRP is an independent prognostic factor for long-term outcomes of MACCE in TVD patients with type 2 diabetes but not in those without type 2 diabetes. Compared to traditional risk factors, hs-CRP improved the risk prediction of adverse cardiovascular events in TVD patients with type 2 diabetes.
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Affiliation(s)
- Lei Guo
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Haichen Lv
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Junjie Wang
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Bo Zhang
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Yifan Zhu
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Xiaoyan Zhang
- Department of Radiology, Fuyang Hospital of Anhui Medical University, Fuyang, People's Republic of China
| | - Hao Zhu
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Xuchen Zhou
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Yunlong Xia
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
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Stătescu C, Anghel L, Tudurachi BS, Leonte A, Benchea LC, Sascău RA. From Classic to Modern Prognostic Biomarkers in Patients with Acute Myocardial Infarction. Int J Mol Sci 2022; 23:9168. [PMID: 36012430 PMCID: PMC9409468 DOI: 10.3390/ijms23169168] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Despite all the important advances in its diagnosis and treatment, acute myocardial infarction (AMI) is still one of the most prominent causes of morbidity and mortality worldwide. Early identification of patients at high risk of poor outcomes through the measurement of various biomarker concentrations might contribute to more accurate risk stratification and help to guide more individualized therapeutic strategies, thus improving prognoses. The aim of this article is to provide an overview of the role and applications of cardiac biomarkers in risk stratification and prognostic assessment for patients with myocardial infarction. Although there is no ideal biomarker that can provide prognostic information for risk assessment in patients with AMI, the results obtained in recent years are promising. Several novel biomarkers related to the pathophysiological processes found in patients with myocardial infarction, such as inflammation, neurohormonal activation, myocardial stress, myocardial necrosis, cardiac remodeling and vasoactive processes, have been identified; they may bring additional value for AMI prognosis when included in multi-biomarker strategies. Furthermore, the use of artificial intelligence algorithms for risk stratification and prognostic assessment in these patients may have an extremely important role in improving outcomes.
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Affiliation(s)
- Cristian Stătescu
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
| | - Larisa Anghel
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
| | - Bogdan-Sorin Tudurachi
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Andreea Leonte
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Laura-Cătălina Benchea
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Radu-Andy Sascău
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
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Li Z, Ding Y, Peng Y, Yu J, Pan C, Cai Y, Dong Q, Zhong Y, Zhu R, Yu K, Zeng Q. Effects of IL-38 on Macrophages and Myocardial Ischemic Injury. Front Immunol 2022; 13:894002. [PMID: 35634320 PMCID: PMC9136064 DOI: 10.3389/fimmu.2022.894002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Macrophages play an important role in clearing necrotic myocardial tissues, myocardial ischemia-reperfusion injury, and ventricular remodeling after myocardial infarction. M1 macrophages not only participate in the inflammatory response in myocardial tissues after infarction, which causes heart damage, but also exert a protective effect on the heart during ischemia. In contrast, M2 macrophages exhibit anti-inflammatory and tissue repair properties by inducing the production of high levels of anti-inflammatory cytokines and fibro-progenitor cells. Interleukin (IL)-38, a new member of the IL-1 family, has been reported to modulate the IL-36 signaling pathway by playing a role similar to that of the IL-36 receptor antagonist, which also affects the production and secretion of macrophage-related inflammatory factors that play an anti-inflammatory role. IL-38 can relieve myocardial ischemia-reperfusion injury by promoting the differentiation of M1 macrophages into M2 macrophages, inhibit the activation of NOD-like receptor thermal protein domain-associated protein 3 (NLRP3) inflammasome, and increase the secretion of anti-inflammatory cytokines, such as IL-10 and transforming growth factor-β. The intact recombinant IL-38 can also bind to interleukin 1 receptor accessory protein-like 1 (IL-1RAPL1) to activate the c-jun N-terminal kinase/activator protein 1 (JNK/AP1) pathway and increase the production of IL-6. In addition, IL-38 regulates dendritic cell-induced cardiac regulatory T cells, thereby regulating macrophage polarization and improving ventricular remodeling after myocardial infarction. Accordingly, we speculated that IL-38 and macrophage regulation may be therapeutic targets for ameliorating myocardial ischemic injury and ventricular remodeling after myocardial infarction. However, the specific mechanism of the IL-38 action warrants further investigation.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Kunwu Yu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiutang Zeng
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Ungurianu A, Zanfirescu A, Grădinaru D, Ionescu-Tîrgoviște C, Dănciulescu Miulescu R, Margină D. Interleukins and redox impairment in type 2 diabetes mellitus: mini-review and pilot study. Curr Med Res Opin 2022; 38:511-522. [PMID: 35067142 DOI: 10.1080/03007995.2022.2033049] [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] [Indexed: 11/03/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) represents a leading cause of morbidity and premature mortality, low-grade inflammation being acknowledged as a key contributor to its development and progression. A tailored therapeutic approach, based on sensitive and specific biomarkers, could allow a more accurate analysis of disease susceptibility/prognostic and of the response to treatment. OBJECTIVES This mini-review and pilot study had two main goals: (1) reviewing the most recent literature encompassing the use of interleukins as inflammatory markers influenced by the redox imbalances in T2DM and (2) assessing parameters that conjunctly evaluate the redox impairment and inflammatory burden of T2DM patients, taking into consideration smoking status, as such group-specific biomarkers are scarcely reported in literature. METHODS Firstly, PubMed database was surveyed to select and review the relevant studies employing interleukins as T2DM biomarkers and to assess if studies using combined inflammatory-redox indices were reported. Then, routine biochemical parameters were assessed in a pilot study -T2DM patients with 3 subgroups: non-smokers, smokers and ex-smokers, were compared to a control group of non-diabetic, apparently healthy non-smokers. Protein (AOPPs, AGEs), lipid/HDL (Amplex Red-based method) oxidative damage and inflammatory status (CRP, IL-1β, IL-6, IL-10) biomarkers were assessed. Cytokine ratios and 2 oxidative-inflammatory status indices were developed (IH1 and IH2) and evaluated. RESULTS We observed significant differences in terms of serum redox and inflammatory status (AOPPs, AGEs, CRP, CRP/HDL, CRP/IL-6, IL-10/IL-6, IH1) between T2DM patients compared to control and, moreover, between the subgroups formed considering smoking status (CRP, CRP/HDL, IH1). Glycemic control strongly influenced inflammatory status biomarkers: glycemia was positively correlated with the inflammatory parameters (CRP/IL-10) and inversely with the anti-inflammatory ones (IL-10, IL-10/IL-1β ratio). CONCLUSIONS Several of the assessed parameters may possess prognostic value for diabetics, especially when comparing subgroups with a different smoking history and could prove useful in clinical practice for assessing disease progress and therapeutic efficacy.
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Affiliation(s)
- Anca Ungurianu
- Department of Biochemistry, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Anca Zanfirescu
- Department of Pharmacology, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Daniela Grădinaru
- Department of Biochemistry, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Rucsandra Dănciulescu Miulescu
- N. Paulescu National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania
- Department of Department of Endocrinology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Denisa Margină
- Department of Biochemistry, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Lin XL, Sun HX, Li FQ, Zhao JY, Zhao DH, Liu JH, Fan Q. Admission high-sensitivity C-reactive protein levels improve the Grace risk score prediction on in-hospital outcomes in acute myocardial infarction patients. Clin Cardiol 2022; 45:282-290. [PMID: 35066901 PMCID: PMC8922537 DOI: 10.1002/clc.23749] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is the main cause of death and disability in cardiovascular and cerebrovascular diseases. Both the Global Registry of Acute Coronary Events (Grace) score and high-sensitivity C-reactive protein (hs-CRP) were associated with prognosis in patients with AMI. However, whether the addition of the hs-CRP to Grace risk score could improve the predictive power of Grace risk score on the prognosis of patients with AMI is unclear. HYPOTHESIS We hypothesized that the inclusion of hs-CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in-hospital outcomes. METHODS We retrospectively enrolled 1804 patients with AMI in the final analysis. Patients were divided into four groups by hs-CRP quartiles. The relation between hs-CRP and Grace risk score was analyzed by Spearman rank correlation. Logistic regression was used to identify independent risk factors. The predictive value of hs-CRP add to Grace risk score was evaluated by C-statistic, net reclassification improvement (NRI), integrated differentiation improvement (IDI), calibration plot, and decision curve analysis. RESULTS The hs-CRP and Grace risk score had a significantly positive correlation (r = .191, p < .001). hs-CRP combined with Grace risk score could improve the ability of Grace risk score alone to correctly redistinguish the occurrence of in-hospital outcome (C-statistic = 0.819, p < .001; NRI = 0.05956, p = .007; IDI = 0.0757, p < .001). CONCLUSION Admission hs-CRP level was a significant independent risk factor for in-hospital outcomes in patients with AMI. The inclusion of hs-CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in-hospital outcomes.
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Affiliation(s)
- Xiao Long Lin
- Department of Cardiology, Beijing An Zhen HospitalCapital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel DiseasesBeijingChaoyangChina
| | - Hao Xuan Sun
- Department of Cardiology, Beijing An Zhen HospitalCapital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel DiseasesBeijingChaoyangChina
| | - Fan Qi Li
- Department of Cardiology, Beijing An Zhen HospitalCapital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel DiseasesBeijingChaoyangChina
| | - Jin Yang Zhao
- Department of Cardiology, Beijing An Zhen HospitalCapital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel DiseasesBeijingChaoyangChina
| | - Dong Hui Zhao
- Department of Cardiology, Beijing An Zhen HospitalCapital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel DiseasesBeijingChaoyangChina
| | - Jing Hua Liu
- Department of Cardiology, Beijing An Zhen HospitalCapital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel DiseasesBeijingChaoyangChina
| | - Qian Fan
- Department of Cardiology, Beijing An Zhen HospitalCapital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel DiseasesBeijingChaoyangChina
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Lu T, Tan L, Xu K, Liu J, Liu C, Zhang G, Shi R, Huang Z. Outcomes of hyperlactatemia on admission in critically ill patients with acute myocardial infarction: A retrospective study from MIMIC-IV. Front Endocrinol (Lausanne) 2022; 13:1015298. [PMID: 36213274 PMCID: PMC9538672 DOI: 10.3389/fendo.2022.1015298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It has not been verified whether there is a correlation between admission hyperlactatemia and outcomes in critically ill patients with acute myocardial infarction (AMI), especially in large data studies, which we aimed to do in this study. METHODS For this retrospective study, we extracted analysis data from a famous online intensive care unit database, the Medical Information Mart for Intensive Care (MIMIC)-IV. Included patients were divided into four groups according to the serum lactate level on admission. Hospital mortality and mortality over time were the main outcomes. To explore the relationship between admission hyperlactatemia and outcomes in critically ill patients with AMI, logistic regression, Cox regression, Kaplan-Meier curves, and subgroup analyses were used. RESULTS 2171 patients matching the selection criteria were enrolled in this study. After adjusting for potential confounding factors, hyperlactatemia on admission contributed to increased short-term mortality in critically ill patients with AMI. The adjusted odds ratio for hospital mortality were 1.62, 3.46 and 5.28 in the mild, moderate, and severe hyperlactatemia groups (95% CI: 1.20-2.18, 2.15-5.58, and 2.20-12.70, respectively). The adjusted hazard ratio for 7-day and 30-day mortality were 1.99 and 1.35 (95% CI: 1.45-2.73 and 1.09-1.67) in the mild hyperlactatemia group, 3.33 and 2.31 (95% CI: 2.22-4.99 and 1.72-3.10) in the moderate hyperlactatemia group, 4.81 and 2.91 (95% CI: 2.86-8.08 and 1.88-4.50) in the severe hyperlactatemia group. The adjusted hazard ratio for 1-year and 5-year mortality were 2.03 and 1.93 (95% CI: 1.58-2.62 and 1.52-2.47) in the moderate hyperlactatemia group, 1.92 and 1.74 (95% CI: 1.28-2.89 and 1.17-2.59) in the severe hyperlactatemia group. Subgroup analyses indicated that the positive correlation between serum lactate level on admission and short-term mortality of critically ill patients with AMI was similar in the subgroups of cardiogenic shock and acute heart failure (P for interaction > 0.05). CONCLUSION Hyperlactatemia, especially moderate and severe hyperlactatemia, on admission is closely related to higher short-term mortality incidence in critically ill patients with AMI. The relationship between serum lactate level on admission and short-term mortality of critical AMI patients is stable in subgroups of cardiogenic shock and acute heart failure.
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Affiliation(s)
- Ting Lu
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
- Department of Critical Care, Changsha Hospital of Traditional Chinese Medicine, Changsha, China
| | - Liao Tan
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Kai Xu
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jia Liu
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chong Liu
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Guogang Zhang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ruizheng Shi
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Ruizheng Shi, ; Zheng Huang,
| | - Zheng Huang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Ruizheng Shi, ; Zheng Huang,
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Tan L, Xu Q, Li C, Liu J, Shi R. High-Normal Serum Magnesium and Hypermagnesemia Are Associated With Increased 30-Day In-Hospital Mortality: A Retrospective Cohort Study. Front Cardiovasc Med 2021; 8:625133. [PMID: 33644132 PMCID: PMC7902876 DOI: 10.3389/fcvm.2021.625133] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/04/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Magnesium, the fourth most abundant mineral nutrient in our body, plays a critical role in regulating ion channels and energy generation, intracardiac conduction, and myocardial contraction. In this study, we assessed the association of admission serum magnesium level with all-cause in-hospital mortality in critically ill patients with acute myocardial infarction (AMI). Methods: Clinical data were extracted from the eICU Collaborative Research Database (eICU-CRD). Only the data for the first intensive care unit (ICU) admission of each patient were used, and baseline data were extracted within 24 h after ICU admission. Logistic regression, Cox regression, and subgroup analyses were conducted to determine the relationship between admission serum magnesium level and 30-day in-hospital mortality in ICU patients with AMI. Results: A total of 9,005 eligible patients were included. In the logistic regression analysis, serum magnesium at 2.2 to ≤2.4 and >2.4 mg/dl levels were both significant predictors of all-cause in-hospital mortality in AMI patients. Moreover, serum magnesium of 2.2 to ≤2.4 mg/dl showed higher risk of in-hospital mortality than magnesium of >2.4 mg/dl (adjusted odds ratio, 1.63 vs. 1.39). The Cox regression analysis yielded similar results (adjusted hazard ratio, 1.36 vs. 1.25). Conclusions: High-normal serum magnesium and hypermagnesemia may be useful and easier predictors for 30-day in-hospital mortality in critically ill patients with AMI.
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Affiliation(s)
- Liao Tan
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China.,Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Qian Xu
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Chan Li
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Liu
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Ruizheng Shi
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
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Lucci C, Cosentino N, Genovese S, Campodonico J, Milazzo V, De Metrio M, Rondinelli M, Riggio D, Biondi ML, Rubino M, Celentano K, Bonomi A, Capra N, Veglia F, Agostoni P, Bartorelli AL, Marenzi G. Prognostic impact of admission high-sensitivity C-reactive protein in acute myocardial infarction patients with and without diabetes mellitus. Cardiovasc Diabetol 2020; 19:183. [PMID: 33081810 PMCID: PMC7576820 DOI: 10.1186/s12933-020-01157-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/10/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND High-sensitivity C-reactive protein (hs-CRP) elevation frequently occurs in acute myocardial infarction (AMI) and is associated with adverse outcomes. Since diabetes mellitus (DM) is characterized by an underlying chronic inflammation, hs-CRP may have a different prognostic power in AMI patients with and without DM. METHODS We prospectively included 2064 AMI patients; hs-CRP was measured at hospital admission. Patients were grouped according to hs-CRP quartiles and DM status. The primary endpoint was a composite of in-hospital mortality, cardiogenic shock, and acute pulmonary edema. Two-year all-cause mortality was the secondary endpoint. RESULTS Twenty-six percent (n = 548) of patients had DM and they had higher hs-CRP levels than non-DM patients (5.32 vs. 3.24 mg/L; P < 0.0001). The primary endpoint incidence in the overall population (7%, 9%, 13%, 22%; P for trend < 0.0001), in DM (14%, 9%, 21%, 27%; P = 0.0001), and non-DM (5%, 8%, 10%, 19%; P < 0.0001) patients increased in parallel with hs-CRP quartiles. The adjusted risk of the primary endpoint increased in parallel with hs-CRP quartiles in DM and non-DM patients but this relationship was less evident in DM patients. In the overall population, the adjusted OR of the primary endpoint associated with an hs-CRP value ≥ 2 mg/L was 2.10 (95% CI 1.46-3.00). For the same risk, hs-CRP was 7 and 2 mg/L in patients with and without DM. A similar behavior was observed for the secondary endpoint when the HR associated with an hs-CRP value ≥ 2 mg/L found in the overall population was 2.25 (95% CI 1.57-3.22). For the same risk, hs-CRP was 8 and 1.5 mg/L in DM and non-DM patients. CONCLUSIONS This study shows that hs-CRP predicts in-hospital outcome and two-year mortality in AMI patients with and without DM. However, in DM patients, the same risk of developing events as in non-DM patients is associated to higher hs-CRP levels.
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Affiliation(s)
- Claudia Lucci
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
| | - Nicola Cosentino
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
| | - Stefano Genovese
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
| | | | | | - Monica De Metrio
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
| | | | - Daniela Riggio
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
| | | | - Mara Rubino
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
| | - Katia Celentano
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
| | - Alice Bonomi
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
| | - Nicolò Capra
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
| | - Fabrizio Veglia
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
- Department of Clinical Sciences and Community Health - Cardiovascular Section, University of Milan, Milan, Italy
| | - Antonio L Bartorelli
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy
- Department of Biomedical and Clinical Sciences, "Luigi Sacco", University of Milan, Milan, Italy
| | - Giancarlo Marenzi
- Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan, 20138, Italy.
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10
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Ma R, Gao L, Liu Y, Du P, Chen X, Li G. LncRNA TTTY15 knockdown alleviates H 2O 2-stimulated myocardial cell injury by regulating the miR-98-5p/CRP pathway. Mol Cell Biochem 2020; 476:81-92. [PMID: 32888161 DOI: 10.1007/s11010-020-03887-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/14/2020] [Indexed: 12/21/2022]
Abstract
Acute myocardial infarction (AMI) can lead to myocardial injury, and long non-coding RNA (lncRNA) has been found to play an important regulatory role in the process of myocardial injury. However, the role and potential mechanisms of lncRNA testis-specific transcript Y-linked 15 (TTTY15) in AMI-induced myocardial injury has not been fully elucidated. Hydrogen peroxide (H2O2)-induced AMI cell model was built and AMI mice model were constructed. Relative expression levels of TTTY15, miR-98-5p and C-reactive protein (CRP) were determined by quantitative real-time PCR (qRT-PCR). Cell counting kit 8 (CCK8) assay, flow cytometry and enzyme-linked immunosorbent assay (ELISA) were employed to assess cell viability, apoptosis, inflammatory response and oxidative stress. Western blot (WB) analysis was used to assess the protein expression levels. The mechanism of TTTY15 was confirmed by dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay. Our results revealed that TTTY15 was upregulated and miR-98-5p was downregulated in AMI patients and H2O2-stimulated myocardial cells. Knockdown of TTTY15 could alleviate H2O2-stimulated myocardial cell injury in vitro and AMI progression in vivo. Bioinformatics analysis and the rescue experiments confirmed that TTTY15 positively regulated H2O2-induced myocardial cell injury via regulating CRP by sponging miR-98-5p. Our research proposed that lncRNA TTTY15 promoted myocardial cell injury by regulating the miR-98-5p/CRP axis, suggesting that TTTY15 might be a potential target for alleviating AMI-caused myocardial cell injury.
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Affiliation(s)
- Rufei Ma
- Department of Clinical Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, No.7 Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Lan Gao
- Department of Clinical Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, No.7 Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Yanhong Liu
- Department of Clinical Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, No.7 Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Pengqiang Du
- Department of Medicine, Fuwai Central China Cardiovascular Hospital, Zhengzhou, 450046, Henan, China
| | - Xiaozhen Chen
- Department of Cardiology, Fuwai Central China Cardiovascular Hospital, Zhengzhou, 450046, Henan, China
| | - Gang Li
- Department of Clinical Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, No.7 Weiwu Road, Zhengzhou, 450003, Henan, China.
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11
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Ziv-Baran T, Wasserman A, Shteinvil R, Zeltser D, Shapira I, Shenhar-Tsarfaty S, Meilik A, Goldiner I, Rogowski O, Berliner S, Halpern P. C-reactive protein and emergency department seven days revisit. Clin Chim Acta 2018; 481:207-211. [DOI: 10.1016/j.cca.2018.03.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 03/19/2018] [Indexed: 01/21/2023]
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