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Saeed A, Farouk MM, Sabri NA, Saleh MA, Ahmed MA. Effect of pentoxifylline on endothelial dysfunction, oxidative stress and inflammatory markers in STEMI patients. Future Sci OA 2024; 10:FSO967. [PMID: 38817362 PMCID: PMC11137834 DOI: 10.2144/fsoa-2023-0266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/24/2024] [Indexed: 06/01/2024] Open
Abstract
Aim: ST-elevation myocardial infarction (STEMI) patients suffer higher mortality and adverse outcomes linked to endothelial dysfunction (ED). Methods: 43 patients were randomized to pentoxifylline (PTX) 400 mg thrice daily (n = 22) or placebo (n = 21). Soluble vascular cell adhesion molecule-1, malondialdehyde, interleukin-1 (IL-1), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) were assessed at baseline and 2 months. Results: After 2 months, no significant difference was observed in markers' levels between the 2 groups. However, a within-group comparison revealed a statistically significant change in hs-CRP in the PTX group (10.057 (9.779-10.331) versus 9.721 (6.102-10.191)), p = 0.032. Conclusion: PTX for 2 months in STEMI patients was safe and well-tolerated but had no significant detectable effect on ED, oxidative stress or inflammatory markers. Clinical Trial Registration: NCT04367935 (ClinicalTrials.gov).
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Affiliation(s)
- Asmaa Saeed
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, 11566, Egypt
| | | | - Nagwa Ali Sabri
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, 11566, Egypt
| | - Mohamed Ayman Saleh
- Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, 11591 Egypt
| | - Marwa Adel Ahmed
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, 11566, Egypt
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Liu S, Jiang H, Dhuromsingh M, Dai L, Jiang Y, Zeng H. Evaluation of C-reactive protein as predictor of adverse prognosis in acute myocardial infarction after percutaneous coronary intervention: A systematic review and meta-analysis from 18,715 individuals. Front Cardiovasc Med 2022; 9:1013501. [PMID: 36465441 PMCID: PMC9708737 DOI: 10.3389/fcvm.2022.1013501] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/24/2022] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Proper prognostic biomarker is of great importance for clinical decision-making in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Although recently emerges plenty of novel inflammatory biomarkers, the canonical inflammatory mediator C-reactive protein still plays an important role in prognosing adverse post-infarction complications. METHODS PubMed, Embase, and Medline were systematically searched from the establishment of databases up to December 2021, conforming with standards set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS A total of 23 studies were eventually eligible for this meta-analysis, including 18,715 individuals. Our findings showed that elevated C-reactive protein (CRP) had a statistically significant superiority in predicting all-cause mortality (OR: 3.22, 95% CI: [2.71, 3.84], p < 0.00001), cardiovascular death (OR: 3.26, 95% CI: [2.30, 4.61], p < 0.00001), major adverse cardiovascular events (MACEs) (OR: 2.85, 95% CI [2.08, 3.90], p < 0.00001), heart failure (OR: 2.29, 95% CI: [1.48, 3.54], p = 0.0002), recurrent myocardial infarction (OR: 1.76, 95% CI: [1.28, 2.43], p < 0.001), and restenosis (OR: 1.71, 95% CI: [1.18, 2.47], p = 0.004). Subgroup analysis implies that CRP had better performance in predicting plenty of hospitalization and short-term (<12 months) adverse prognosis than long-term prognosis and Asian patients with elevated CRP were under more risk in adverse prognosis after PCI than Europeans. CONCLUSION Our meta-analysis suggests that CRP is a prospective predictor of the prognosis in patients with AMI undergoing PCI, especially in hospitalization and short-term and in the Asian group.
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Affiliation(s)
- Shijie Liu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, Hubei, China
| | - Hongcheng Jiang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, Hubei, China
| | - Menaka Dhuromsingh
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, Hubei, China
| | - Lei Dai
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, Hubei, China
| | - Yue Jiang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hesong Zeng
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, Hubei, China
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