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Psarakis G, Farmakis I, Zafeiropoulos S, Kourti O, Konstantas O, Vrana E, Baroutidou A, Tsolakidis C, Touriki AV, Psathas T, Graidis S, Spyridaki K, Daniilidou A, Tsakiridis K, Tsalikakis D, Skoura L, Karvounis H, Giannakoulas G. Predictive Role of Platelet-Associated Indices on Admission and Discharge in the Long-Term Prognosis of Acute Coronary Syndrome Patients. Angiology 2021; 73:453-460. [PMID: 34779272 DOI: 10.1177/00033197211052134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our study aimed to investigate the association between platelet indices and their in-hospital change and long-term prognosis in acute coronary syndrome (ACS). Data from a randomized controlled trial (NCT02927808) recruiting ACS patients were analyzed (survival analysis). The examined variables were platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) on admission and discharge, as well as their alteration during hospitalization. The primary endpoint was major adverse cardiac events (MACE) (cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke or hospitalization for unstable angina) and all-cause mortality, while secondary endpoints were all-cause hospitalization and bleeding events. The study included 252 patients with a follow-up of 39 (28-45) months. In the univariate analysis, MACE was associated with discharge PC [hazard ratio (HR) 2.20, 95% confidence interval (CI) 1.10-4.40], discharge MPV (HR 0.48, 95% CI 0.25-0.94), and in-hospital PC difference (HR 0.25, 95% CI 0.13-0.51). In the multivariable analysis, only in-hospital PC decrease correlated with lower MACE incidence (adjusted HR .27, 95% CI 0.14-0.54) and lower all-cause hospitalization risk (adjusted HR 0.36, 95% CI 0.19-0.68). PC reduction during hospitalization for ACS is an independent predictor of better prognosis.
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Affiliation(s)
- Georgios Psarakis
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | - Ioannis Farmakis
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | | | - Olga Kourti
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | - Orestis Konstantas
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | - Eleni Vrana
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | - Amalia Baroutidou
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | | | | | - Thomas Psathas
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | - Spyridon Graidis
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | | | | | | | - Dimitrios Tsalikakis
- Department of Informatics and Telecommunication Engineering, University of Western Macedonia, Kozani, Greece
| | - Lemonia Skoura
- Department of Microbiology, Medical School, 37782Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Masud R, Anjum A, Anwar M, Khan W, Shahzad M, Jawwad G. The risk stratification of coronary vascular disease as linked to homocysteine, its modulating genes, genetic polymorphisms, conventional predictors, and with antihypertensive medicaments. CHINESE J PHYSIOL 2021; 64:298-305. [DOI: 10.4103/cjp.cjp_71_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kolovou G. The need to improve cardiac care after acute coronary syndrome. Hellenic J Cardiol 2020; 60:254-255. [PMID: 31901256 DOI: 10.1016/j.hjc.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/05/2019] [Indexed: 01/12/2023] Open
Abstract
Patients who experience acute coronary syndrome (ACS) are at increased risk of new cardiovascular (CV) events. The main strategies for prevention of recurrence of CV events is the protection from ruptured plaque, thrombus formation, occlusion or downstream embolization in the coronary artery. The percutaneous coronary intervention (PCI) with stenting and anticoagulants, 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (HMGCoAi, commonly called statins) and neurohormonal inhibition, has led to a notable decrease in 1-year mortality events. Today it is well documented that all patients with an ACS should be treated early, intensively and continuously for lowering the LDL-C values to the recommended goals. Regularly interviewing by trained health care personnel and post-discharge follow-up of patients after ACS seems to be more effective concerning adherence to statin for achieving LDL-C treatment goals compared with the standard of care.
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Affiliation(s)
- Genovefa Kolovou
- Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
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Abstract
Many studies have been performed concerning the potential role of Helicobacter pylori (H. pylori) in different extra-gastric diseases. Ischemic heart disease (IHD) remains the leading cause of mortality in developed countries. The traditional cardiovascular risk factors could not predict all cases of IHD. Hence, the scientists explore other potential etiologic factors, especially infections. H. pylori infection has been suspected to have a role in the pathogenesis of atherosclerosis. However, after 25 years from the first description, the role of the bacterium in the pathogenesis of IHD remains controversial and enigmatic. Since H. pylori infection is persistent and stimulates both a local and a systemic immune response that could cause significant changes in the markers of inflammation like cytokines, C-reactive protein, heat shock protein, fibrinogen, triglycerides, high density lipoprotein, it has been supposed that the outcomes of this process are atherosclerosis and a prothrombotic state which eventually leads to IHD. Alternative pathogenic mechanisms have been hypothesized, including the occurrence of molecular antigenicity. This hypothesis supposed that H. pylori could provoke autoimmunity as a result of molecular mimicry. The eradication of H. pylori infection as cardiovascular prevention strategy has been the object of some studies. However, the results are of difficult interpretation. Further studies, especially with a cohort and interventional design, have to be performed to reveal the potential relationship between H. pylori and IHD.
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Affiliation(s)
- Irena Mladenova
- Department of Hygiene, Epidemiology and Infectious Diseases, Faculty of Medicine, Trakia University, Stara Zagora, Bulgaria -
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