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Kim CH, Lee SH, Kim HK, Kim MC, Kim JH, Hong YJ, Ahn YK, Jeong MH, Hur SH, Kim DI, Chang K, Park HS, Bae JW, Jeong JO, Park YH, Yun KH, Yoon CH, Kim Y, Hwang JY, Kim HS, Choi KH, Park TK, Yang JH, Song YB, Hahn JY, Choi SH, Gwon HC, Lee JM. Prognostic Implications of N-Terminal Pro-B-Type Natriuretic Peptide in Patients With Non-ST-Elevation Myocardial Infarction. Circ J 2024; 88:1237-1245. [PMID: 38599833 DOI: 10.1253/circj.cj-24-0129] [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: 04/12/2024]
Abstract
BACKGROUND Limited data exist regarding the prognostic implications of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with non-ST-elevation myocardial infarction (NSTEMI) who undergo percutaneous coronary intervention (PCI). METHODS AND RESULTS Of 13,104 patients in the nationwide Korea Acute Myocardial Infarction Registry-National Institutes of Health, 3,083 patients with NSTEMI who underwent PCI were included in the present study. The primary endpoint was major adverse cardiovascular events (MACE) at 3 years, a composite of all-cause death, recurrent myocardial infarction, unplanned repeat revascularization, and admission for heart failure. NT-proBNP was measured at the time of initial presentation for the management of NSTEMI, and patients were divided into a low (<700 pg/mL; n=1,813) and high (≥700 pg/mL; n=1,270) NT-proBNP group. The high NT-proBNP group had a significantly higher risk of MACE, driven primarily by a higher risk of cardiac death or admission for heart failure. These results were consistent after confounder adjustment by propensity score matching and inverse probability weighting analysis. CONCLUSIONS In patients with NSTEMI who underwent PCI, an initial elevated NT-proBNP concentration was associated with higher risk of MACE at 3 years, driven primarily by higher risks of cardiac death or admission for heart failure. These results suggest that the initial NT-proBNP concentration may have a clinically significant prognostic value in NSTEMI patients undergoing PCI.
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Affiliation(s)
- Chang Hoon Kim
- Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Seung Hun Lee
- Division of Cardiology, Department of Internal Medicine, Heart Center, Chonnam National University Hospital, Chonnam National University Medical School
| | - Hyun Kuk Kim
- Department of Internal Medicine and Cardiovascular Center, Chosun University Hospital, University of Chosun College of Medicine
| | - Min Chul Kim
- Division of Cardiology, Department of Internal Medicine, Heart Center, Chonnam National University Hospital, Chonnam National University Medical School
| | - Ju Han Kim
- Division of Cardiology, Department of Internal Medicine, Heart Center, Chonnam National University Hospital, Chonnam National University Medical School
| | - Young Joon Hong
- Division of Cardiology, Department of Internal Medicine, Heart Center, Chonnam National University Hospital, Chonnam National University Medical School
| | - Young Keun Ahn
- Division of Cardiology, Department of Internal Medicine, Heart Center, Chonnam National University Hospital, Chonnam National University Medical School
| | - Myung Ho Jeong
- Division of Cardiology, Department of Internal Medicine, Heart Center, Chonnam National University Hospital, Chonnam National University Medical School
| | | | - Doo Il Kim
- Department of Cardiology, Inje University Haeundae Baek Hospital, Inje University College of Medicine
| | - Kiyuk Chang
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital
| | - Jang-Whan Bae
- Department of Internal Medicine, College of Medicine, Chungbuk National University
| | - Jin-Ok Jeong
- Chungnam National University Hospital, Chungnam National University College of Medicine
| | - Yong Hwan Park
- Samsung Changwon Hospital, Sungkyunkwan University School of Medicine
| | | | | | - Yisik Kim
- Chonbuk National University Hospital and Chonbuk National University Medical School
| | - Jin-Yong Hwang
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine
| | - Hyo-Soo Kim
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital
| | - Ki Hong Choi
- Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Taek Kyu Park
- Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Jeong Hoon Yang
- Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Young Bin Song
- Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Joo-Yong Hahn
- Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Seung-Hyuk Choi
- Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Hyeon-Cheol Gwon
- Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Joo Myung Lee
- Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
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Liu Y, Du L, Li L, Xiong L, Luo H, Kwaku E, Mei X, Wen C, Cui YY, Zhou Y, Zeng L, Li S, Wang K, Zheng J, Liu Z, Hu H, Yue R. Development and validation of a machine learning-based readmission risk prediction model for non-ST elevation myocardial infarction patients after percutaneous coronary intervention. Sci Rep 2024; 14:13393. [PMID: 38862634 PMCID: PMC11166920 DOI: 10.1038/s41598-024-64048-x] [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: 12/15/2023] [Accepted: 06/04/2024] [Indexed: 06/13/2024] Open
Abstract
To investigate the factors that influence readmissions in patients with acute non-ST elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI) by using multiple machine learning (ML) methods to establish a predictive model. In this study, 1576 NSTEMI patients who were hospitalized at the Affiliated Hospital of North Sichuan Medical College were selected as the research subjects. They were divided into two groups: the readmitted group and the non-readmitted group. The division was based on whether the patients experienced complications or another incident of myocardial infarction within one year after undergoing PCI. Common variables selected by univariate and multivariate logistic regression, LASSO regression, and random forest were used as independent influencing factors for NSTEMI patients' readmissions after PCI. Six different ML models were constructed using these common variables. The area under the ROC curve, accuracy, sensitivity, and specificity were used to evaluate the performance of the six ML models. Finally, the optimal model was selected, and a nomogram was created to visually represent its clinical effectiveness. Three different methods were used to select seven representative common variables. These variables were then utilized to construct six different ML models, which were subsequently compared. The findings indicated that the LR model exhibited the most optimal performance in terms of AUC, accuracy, sensitivity, and specificity. The outcome, admission mode (walking and non-walking), communication ability, CRP, TC, HDL, and LDL were identified as independent predicators of readmissions in NSTEMI patients after PCI. The prediction model constructed by the LR algorithm was the best. The established column graph model established proved to be effective in identifying high-risk groups with high accuracy and differentiation. It holds a specific predictive value for the occurrence of readmissions after direct PCI in NSTEMI patients.
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Affiliation(s)
- Yanxu Liu
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Linqin Du
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Lan Li
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Lijuan Xiong
- Department of Cardiology, People's Hospital of Guang'an District, Guang'an, 638550, People's Republic of China
| | - Hao Luo
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Eugene Kwaku
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
- Family Health University College and Hospital, Opposite Kofi Annan International Peace Keeping Training Center, Teshie, Accra, Ghana
| | - Xue Mei
- School of Pharmacy, Institute of Material Medica, North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China
| | - Cong Wen
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Yang Yang Cui
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Yang Zhou
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Lang Zeng
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Shikang Li
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Kun Wang
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Jiankang Zheng
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Zonglian Liu
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Houxiang Hu
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China
| | - Rongchuan Yue
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, 637000, Sichuan Province, People's Republic of China.
- Department of Cardiology, People's Hospital of Guang'an District, Guang'an, 638550, People's Republic of China.
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Li HX, Ma Y, Yan YX, Zhai XK, Xin MY, Wang T, Xu DC, Song YT, Song CD, Pan CX. The purified extract of steamed Panax ginseng protects cardiomyocyte from ischemic injury via caveolin-1 phosphorylation-mediating calcium influx. J Ginseng Res 2023; 47:755-765. [PMID: 38107394 PMCID: PMC10721475 DOI: 10.1016/j.jgr.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 12/19/2023] Open
Abstract
Background Caveolin-1, the scaffolding protein of cholesterol-rich invaginations, plays an important role in store-operated Ca2+ influx and its phosphorylation at Tyr14 (p-caveolin-1) is vital to mobilize protection against myocardial ischemia (MI) injury. SOCE, comprising STIM1, ORAI1 and TRPC1, contributes to intracellular Ca2+ ([Ca2+]i) accumulation in cardiomyocytes. The purified extract of steamed Panax ginseng (EPG) attenuated [Ca2+]i overload against MI injury. Thus, the aim of this study was to investigate the possibility of EPG affecting p-caveolin-1 to further mediate SOCE/[Ca2+]i against MI injury in neonatal rat cardiomyocytes and a rat model. Methods PP2, an inhibitor of p-caveolin-1, was used. Cell viability, [Ca2+]i concentration were analyzed in cardiomyocytes. In rats, myocardial infarct size, pathological damages, apoptosis and cardiac fibrosis were evaluated, p-caveolin-1 and STIM1 were detected by immunofluorescence, and the levels of caveolin-1, STIM1, ORAI1 and TRPC1 were determined by RT-PCR and Western blot. And, release of LDH, cTnI and BNP was measured. Results EPG, ginsenosides accounting for 57.96%, suppressed release of LDH, cTnI and BNP, and protected cardiomyocytes by inhibiting Ca2+ influx. And, EPG significantly relieved myocardial infarct size, cardiac apoptosis, fibrosis, and ultrastructure abnormality. Moreover, EPG negatively regulated SOCE via increasing p-caveolin-1 protein, decreasing ORAI1 mRNA and protein levels of ORAI1, TRPC1 and STIM1. More importantly, inhibition of the p-caveolin-1 significantly suppressed all of the above cardioprotection of EPG. Conclusions Caveolin-1 phosphorylation is involved in the protective effects of EPG against MI injury via increasing p-caveolin-1 to negatively regulate SOCE/[Ca2+]i.
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Affiliation(s)
- Hai-Xia Li
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan Province, China
- Key Laboratory of Targeting Therapy and Diagnosis for Critical Diseases, Zhengzhou, Henan Province, China
| | - Yan Ma
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan Province, China
| | - Yu-Xiao Yan
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan Province, China
| | - Xin-Ke Zhai
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan Province, China
| | - Meng-Yu Xin
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan Province, China
| | - Tian Wang
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan Province, China
| | - Dong-Cao Xu
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan Province, China
| | - Yu-Tong Song
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan Province, China
| | - Chun-Dong Song
- The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, 9 Renmin Road, Zhengzhou, Henan Province, China
| | - Cheng-Xue Pan
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan Province, China
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