Release kinetics of early ischaemic biomarkers in a clinical model of acute myocardial infarction

Heart ◽  
2014 ◽  
Vol 100 (8) ◽  
pp. 652-657 ◽  
Author(s):  
Christoph Liebetrau ◽  
Holger M Nef ◽  
Oliver Dörr ◽  
Luise Gaede ◽  
Jedrzej Hoffmann ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Release Kinetics ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Fatty Acid Binding ◽  
Continuous Increase ◽  
Clinical Model ◽  
Additional Information ◽  
Coronary Syndrome ◽  
Kinetics Of

ObjectiveTo determine the release kinetics of different biomarkers with potential as novel early ischaemic biomarkers in patients with acute coronary syndrome (ACS); it is difficult to establish the detailed release kinetics in patients with acute myocardial infarction (AMI).MethodsWe analysed the release kinetics of soluble fms-like tyrosine kinase (sFlt-1), ischaemia modified albumin (IMA), and heart-type fatty acid binding protein (hFABP) in patients with hypertrophic obstructive cardiomyopathy who were undergoing transcoronary ablation of septal hypertrophy (TASH), a procedure mimicking AMI. Consecutive patients (n=21) undergoing TASH were included. Blood samples were collected before TASH and 15, 30, 45, 60, 75, 90, and 105 min and 2, 4, 8, and 24 h after TASH. sFlt-1 and hFABP were quantified in serum, and IMA was quantified in plasma using immunoassays.ResultssFLT-1 and hFABP increased significantly 15 min after induction of AMI vs baseline as follows: sFlt-1, 3657.5 ng/L (IQR 2302.3–4475.0) vs 76.0 ng/L (IQR 71.2–88.8) (p<0.001); hFABP, 9.0 ng/mL (IQR 7.0–15.4) vs 4.6 ng/mL (IQR 3.4–7.1) (p<0.001). sFlt-1 demonstrated a continuous decrease after the 15th min. hFABP showed a continuous increase until the 8th hour with a decline afterwards. The IMA concentrations increased significantly 30 min after induction of AMI vs baseline, with values of 26.0 U/mL (IQR 21.8–38.6) vs 15.6 U/mL (IQR 10.1–24.7) (p=0.02), and then decreased after 75 min.ConclusionssFlt-1 and hFABP increased very early after induction of myocardial ischaemia, showing different release kinetics. The additional information provided by these findings is helpful for developing their potential combined use with cardiac troponins in patients with suspected AMI.

scholarly journals Release Kinetics of Inflammatory Biomarkers in a Clinical Model of Acute Myocardial Infarction

2015 ◽  
Vol 116 (5) ◽  
pp. 867-875 ◽  
Author(s):  
Christoph Liebetrau ◽  
Jedrzej Hoffmann ◽  
Oliver Dörr ◽  
Luise Gaede ◽  
Johannes Blumenstein ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Release Kinetics ◽  
Inflammatory Biomarkers ◽  
Clinical Model ◽  
Kinetics Of

Release kinetics of N-terminal pro-B-type natriuretic peptide in a clinical model of acute myocardial infarction

2014 ◽  
Vol 429 ◽  
pp. 34-37 ◽  
Author(s):  
Christoph Liebetrau ◽  
Luise Gaede ◽  
Oliver Dörr ◽  
Christian Troidl ◽  
Sandra Voss ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Natriuretic Peptide ◽  
Release Kinetics ◽  
Clinical Model ◽  
Kinetics Of

scholarly journals RELEASE KINETICS OF GALECTIN-3, GDF-15 AND NT-PROBNP IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

2014 ◽  
Vol 63 (12) ◽  
pp. A255
Author(s):  
Christoph Liebetrau ◽  
Luise Gaede ◽  
Oliver Dörr ◽  
Sebastian Wolter ◽  
Christian Troidl ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Release Kinetics ◽  
Galectin 3 ◽  
Kinetics Of

scholarly journals Reference Values and Release Kinetics of B-Type Natriuretic Peptide Signal Peptide in Patients with Acute Myocardial Infarction

2015 ◽  
Vol 61 (12) ◽  
pp. 1532-1539 ◽  
Author(s):  
Christoph Liebetrau ◽  
Luise Gaede ◽  
Oliver Dörr ◽  
Johannes Blumenstein ◽  
Stefanie Rosenburg ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Natriuretic Peptide ◽  
Signal Peptide ◽  
Troponin T ◽  
Reference Group ◽  
Release Kinetics ◽  
Structural Heart Disease ◽  
Time Points ◽  
Kinetics Of

Abstract BACKGROUND The signal peptide for human B-type natriuretic peptide preprohormone (BNPsp), which is released from cardiomyocytes, is increased in plasma of patients with acute myocardial infarction (AMI); however, its exact release kinetics have not been defined. METHODS We measured BNPsp and high-sensitivity cardiac troponin T (hs-cTnT) in a reference group of individuals without structural heart disease (n = 285) and determined the release kinetics of these biomarkers in patients (n = 29) with hypertrophic obstructive cardiomyopathy undergoing transcoronary ablation of septal hypertrophy (TASH), a procedure allowing exact timing of onset of iatrogenic AMI. Blood samples were collected before TASH and at numerous preselected time points after TASH. RESULTS The reference median BNPsp concentration was 53.4 pmol/L [interquartile range (IQR) 47.0–61.0; 95th percentile 85.9 pmol/L; 99th percentile 116.3 pmol/L]. Baseline concentrations in patients undergoing TASH were higher than in the reference group [91.9 pmol/L (IQR 62.9–116.4); P &lt; 0.0001]. BNPsp increased significantly, peaking at 15 min after induction of AMI [149.6 pmol/L (109.5–204.9) vs baseline; P = 0.004] and declining slowly thereafter, falling below the preprocedural value after 8 h (P = 0.014). hs-cTnT increased significantly 15 min after induction of AMI [26 ng/L (19–39) vs 18 ng/L (11–29); P = 0.001] and remained high at all later time points. CONCLUSIONS BNPsp concentrations increased immediately after AMI induction, providing early evidence of myocardial injury. The release kinetics of BNPsp differed from those of hs-cTnT. These findings provide information that should help in establishing the diagnostic value of BNPsp in the setting of early AMI.

scholarly journals Release Kinetics of Copeptin in Patients Undergoing Transcoronary Ablation of Septal Hypertrophy

2013 ◽  
Vol 59 (3) ◽  
pp. 566-569 ◽  
Author(s):  
Christoph Liebetrau ◽  
Holger Nef ◽  
Sebastian Szardien ◽  
Oliver Dörr ◽  
Matthias Willmer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin T ◽  
Release Kinetics ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Serum Creatine Kinase ◽  
Median Baseline ◽  
Septal Hypertrophy ◽  
Baseline Values ◽  
Kinetics Of ◽  
Rule Out

BACKGROUND The release kinetics of copeptin in patients with acute myocardial infarction (AMI) have been difficult to establish. METHODS We analyzed the release kinetics of copeptin in patients with hypertrophic obstructive cardiomyopathy undergoing transcoronary ablation of septal hypertrophy (TASH) as a model of AMI. We included 21 consecutive patients who underwent TASH. Blood samples were collected before and at 15, 30, 45, 60, 75, 90, and 105 min, and at 2, 4, 8, and 24 h after TASH. Serum copeptin was quantified by a sandwich immunoluminometric assay. RESULTS All patients had copeptin concentrations below the 99th percentile at baseline. The median copeptin concentration was significantly increased at 30 min [16.0 pmol/L; interquartile range (IQR), 13.4–20.2 pmol/L], compared with the median baseline concentration (6.6 pmol/L; IQR, 5.3–8.3 pmol/L; P = 0.002). The copeptin concentration peaked 90 min after induction of myocardial infarction and returned to baseline concentrations (median, 8.2 pmol/L; IQR, 6.3–10.1) after 24 h, compared with the above baseline values (P = 0.06). Serum creatine kinase (CK) activities were significantly increased above baseline values by 1 day after TASH [median maximal postprocedural CK activity, 935.0 U/L (IQR, 545.5–1115.0 U/L); median baseline CK activity, 80.0 U/L (IQR, 63.5–109.0 U/L); P &lt; 0.001]. CONCLUSIONS Our results provide additional evidence that early rule-out of suspected AMI is possible by using the copeptin concentration in combination with cardiac troponin T.

scholarly journals Association of Dephosphorylated-Uncarboxylated Matrix Gla Protein and Risk of Major Bleeding in Patients Presenting with Acute Myocardial Infarction

Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 733
Author(s):  
Admira Bilalic ◽  
Tina Ticinovic Kurir ◽  
Josip A. Borovac ◽  
Marko Kumric ◽  
Daniela Supe-Domic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Major Bleeding ◽  
Plasma Levels ◽  
Adverse Outcomes ◽  
Matrix Gla Protein ◽  
Coagulation Cascade ◽  
Bleeding Tendency ◽  
Coronary Syndrome ◽  
Bleeding Score

The “Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines” (CRUSADE) score emerged as a predictor of major bleeding in patients presenting with the acute coronary syndrome. On the other hand, previous studies established the association of dephosphorylated-uncarboxylated Matrix Gla protein (dp-ucMGP) and vitamin K, as well as their subsequent impact on coagulation cascade and bleeding tendency. Therefore, in the present study, we explored if dp-ucMGP plasma levels were associated with CRUSADE bleeding score. In this cross-sectional study, physical examination and clinical data, including plasma dp-ucMGP levels, were obtained from 80 consecutive patients with acute myocardial infarction (AMI). A significant positive correlation was found between CRUSADE bleeding score and both dp-ucMGP plasma levels (r = 0.442, p < 0.001) and risk score of in-hospital mortality (r = 0.520, p < 0.001), respectively. In comparing the three risk groups of risk for in-hospital bleeding, the high/very high-risk group had significantly higher dp-ucMGP levels from both very low/low group (1277 vs. 794 pmol/L, p < 0.001) and the moderate group (1277 vs. 941 pmol/L, p = 0.047). Overall, since higher dp-ucMGP levels were associated with elevated CRUSADE score and prolonged hemostasis parameters, this may suggest that there is a biological link between dp-ucMGP plasma levels and the risk of bleeding in patients who present with AMI.

Primary care physician services and the frequency of comorbidities in patients with acute myocardial infarction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
R King ◽  
D Giedrimiene
Keyword(s):  
Myocardial Infarction ◽  
Primary Care ◽  
Acute Myocardial Infarction ◽  
Primary Care Physician ◽  
Care Physician ◽  
Adverse Outcomes ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background The management of patients with multiple comorbidities represents a significant burden on healthcare each year. Despite requiring regular medical care to treat chronic conditions, a large number of these patients may not receive proper care. Significant disparities have been identified in patients with multiple comorbidities and those who experience acute coronary syndrome or acute myocardial infarction (AMI). Only limited data exists to identify the impact of comorbidities and utilization of primary care physician (PCP) services on the development of adverse outcomes, such as AMI. Purpose The primary objective was to analyze how PCP services utilization can be associated with comorbidities in patients who experienced an AMI. Methods This study was based on retrospective data analysis which included 250 patients admitted to the Hartford Hospital Emergency Department (ED) for an AMI. Out of these, 27 patients were excluded due to missing documentation. Collected data included age, gender, medications and recorded comorbidities, such as hypertension, hyperlipidemia, diabetes mellitus (DM), chronic kidney disease (CKD) and previous arrhythmia. Each patient was assessed regarding utilization of PCP services. Statistical analysis was performed in order to identify differences between patients with documented PCP services and those without by using the Chi-square test. Results The records allowed for identification of documented PCP services for 172 out of 223 (77.1%) patients. The most common comorbidities were hypertension and hyperlipidemia: in 165 (74.0%) and 157 (70.4%) cases respectively. The most frequent comorbidity was hypertension: 137 out of 172 (79.7%) in pts with PCP vs 28 out of 51 (54.9%) without PCP, and significantly more often in patients with PCP, p&lt; 0.001. Hyperlipidemia was the second most frequent comorbidity: in 130 out of 172 (75.6%) vs 27 out of 51 (52.9%) accordingly, and also significantly more often (p&lt; 0.002) in patients with PCP services. The number of comorbidities ranged from 0-5, including 32 (14.3%) patients without comorbidities: 16 (9.3%) with a PCP and 16 (31.4%) without PCP services. The majority of patients - 108 (48.5% of 223), had 2-3 documented comorbidities: 89 (51.8%) had two and 19 (34.6%) had three. The remaining 40 (17.9%) patients had 4-5 comorbidities: 37 (21.5%) of them with a PCP and 3 (10.3%) without, with a significant difference (p &lt; 0.001) found for patients with a higher number of comorbidities who utilized PCP services. Conclusions Our study shows that the majority of patients who presented with an AMI had one or more comorbidities. Furthermore, patients who did not utilize PCP services had fewer identified comorbidities. This suggests that there may be a significant number of patients who experienced AMI with undiagnosed comorbidities due to not having access to PCP services.

scholarly journals Long-Term Prognostic Value of Cognitive Impairment on Top of Frailty in Older Adults after Acute Coronary Syndrome

2021 ◽  
Vol 10 (3) ◽  
pp. 444
Author(s):  
Juan Sanchis ◽  
Clara Bonanad ◽  
Sergio García-Blas ◽  
Vicent Ruiz ◽  
Agustín Fernández-Cisnal ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Older Adults ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Prognostic Value ◽  
Adult Survivors ◽  
Prognostic Information ◽  
Coronary Syndrome

Frailty is a marker of poor prognosis in older adults after acute coronary syndrome. We investigated whether cognitive impairment provides additional prognostic information. The study population consisted of a prospective cohort of 342 older (>65 years) adult survivors after acute coronary syndrome. Frailty (Fried score) and cognitive function (Pfeiffer’s Short Portable Mental Status Questionnaire—SPMSQ) were assessed at discharge. The endpoints were mortality or acute myocardial infarction at 8.7-year median follow-up. Patient distribution according to SPMSQ results was: no cognitive impairment (SPMSQ = 0 errors; n = 248, 73%), mild impairment (SPMSQ = 1–2 errors; n = 52, 15%), and moderate to severe impairment (SPMSQ ≥3 errors; n = 42, 12%). A total of 245 (72%) patients died or had an acute myocardial infarction, and 216 (63%) patients died. After adjustment for clinical data, comorbidities, and Fried score, the SPMSQ added prognostic value for death or myocardial infarction (per number of errors; HR = 1.11, 95%, CI 1.04–1.19, p = 0.002) and death (HR = 1.11, 95% 1.03–1.20, p = 0.007). An SPMSQ with ≥3 errors identified the highest risk subgroup. Geriatric conditions (SPSMQ and Fried score) explained 19% and 43% of the overall chi-square of the models for predicting death or myocardial infarction and death, respectively. Geriatric assessment after acute coronary syndrome should include both frailty and cognitive function. This is particularly important given that cognitive impairment without dementia can be subclinical and thus remain undetected.

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