Tag: acute coronary syndrome

Clinical Significance of PCSK9 and Soluble P-selectin in Predicting Major Adverse Cardiovascular Events After Primary Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome

Announcing a new article publication for Cardiovascular Innovations and Applications journal.    This study aimed at investigating the association of proprotein convertase subtilisin/kexin type 9 (PCSK9) with soluble P-selectin (sP-selectin), and their values in predicting major adverse cardiovascular events (MACE) at 1-year follow-up in patients with acute coronary syndrome (ACS) receiving dual antiplatelet therapy after primary percutaneous coronary intervention (PCI).

A total of 563 patients with ACS who underwent primary PCI were prospectively recruited from March 2020 to June 2021. The baseline levels of PCSK9, sP-selectin, and other platelet reactivity biomarkers were determined using enzyme-linked immunosorbent assays.

sP-selectin and ox-LDL levels significantly increased with increasing PCSK9 tertiles. High sP-selectin was associated with high PCSK9 levels, and PCSK9 was positively correlated with sP-selectin. Patients with both PCSK9 >17.4 ng/mL and sP-selectin >7.2 ng/mL had a significantly higher incidence of MACE than patients with lower levels. Multivariate analysis indicated that high sP-selectin and PCSK9 levels were independent risk factors for MACE, and the combination of PCSK9 and sP-selectin had better predictive value than each biomarker alone.

PCSK9 and sP-selectin may be potential predictive biomarkers for 1-year prognosis in patients with ACS after primary PCI.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0087

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Yao Yao, Qining Qiu and Xiaoye Li et al. Clinical Significance of PCSK9 and Soluble P-selectin in Predicting Major Adverse Cardiovascular Events After Primary Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome. CVIA. 2024. Vol. 9(1). DOI: 10.15212/CVIA.2023.0087

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Access to Cardiac Rehabilitation: Hurdles and Hopes for Improvement

Announcing a new article publication for Cardiovascular Innovations and Applications journal.

Consistent evidence gathered over many years supports the benefits of cardiac rehabilitation, including decreases in mortality and hospitalizations, and increase in quality of life. In one study of 601,099 Medicare patients older than 65 years with coronary disease, 5-year mortality was lower in patients who participated in cardiac rehabilitation than those who did not (16.3% versus 24.6%, respectively, P < 0.0001). Another study has shown significantly fewer hospitalizations for heart failure among patients who participated in cardiac rehabilitation than those who did not: the patients who underwent cardiac rehabilitation had 11 admissions for a total of 41 hospitalized days over a 24 week period, whereas those who did not had 33 admissions for a total of 187 hospitalized days (P < 0.001). The clinical benefits of cardiac rehabilitation, as documented in both young and older participants, include increased exercise capacity, energy and total quality of life.

Although cardiac rehabilitation is a class 1 indication for patients who have sustained acute coronary syndrome as well as those with heart failure, it is grossly underused. In one study, only 24.4% of a cohort of 366,103 Medicare patients with a qualifying diagnosis for cardiac rehabilitation assessed from 2016 to 2017 participated in cardiac rehabilitation. Of those who participated, only 26.9% completed the program. A closer evaluation of the barriers preventing referral, enrolment and completion of cardiac rehabilitation is needed to better understand the limitations and to promote solutions to these problems.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0074

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Natalie J. Bracewell and Ellen C. Keeley. Access to Cardiac Rehabilitation: Hurdles and Hopes for Improvement. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0074

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Combination of Neutrophil Count and Gensini Score as a Prognostic Marker in Patients with Acute Coronary Syndrome and Uncontrolled Type 2 Diabetes Mellitus Undergoing Percutaneous Coronary Intervention

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Several biomarkers have been studied as prognostic indicators among people with diabetes and coronary artery disease (CAD). The purpose of this study was to determine the prognostic value of neutrophil counts and the Gensini score in patients with type 2 diabetes (T2DM) and Acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).

A total of 694 people with ACS and T2DM who simultaneously had elevated HBA1c received PCI. Spearman rank correlation estimates were used for correlation evaluation. Multivariate Cox regression and Kaplan-Meier analysis were used to identify characteristics associated with major adverse cardiovascular and cerebrovascular events (MACCEs) and patient survival. The effects of single- and multi-factor indices on MACCEs were evaluated through receiver operating characteristic curve analysis.

The Gensini score and neutrophil count significantly differed between the MACCE and non-MACCE groups among patients receiving PCI who had concomitant ACS and T2DM with elevated HBA1c (P<0.001). The Gensini score and neutrophil count were strongly associated with MACCEs (log-rank, P<0.001). The Gensini score and neutrophil count, alone or in combination, were predictors of MACCEs, according to multivariate Cox regression analysis (adjusted hazard ratio [HR], 1.005; 95% confidence interval [CI], 1.002–1.008; P=0.002; adjusted HR, 1.512; 95% CI, 1.005–2.274; P=0.047, respectively). The Gensini score was strongly associated with neutrophil count (variance inflation factor ≥ 5). Area under the curve analysis revealed that the combination of multivariate factors predicted the occurrence of MACCEs better than any single variable.

In patients with T2DM and ACS with elevated HBA1c who underwent PCI, both the Gensini score and neutrophil count were independent predictors of outcomes. The combination of both predictors has a higher predictability.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0051

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Yanyan Xu, Zhen Qin and Jiamin Gao et al. Combination of Neutrophil Count and Gensini Score as a Prognostic Marker in Patients with ACS and Uncontrolled T2DM Undergoing PCI. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0051

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Incidence, Predictors and Associations Between In-Hospital Bleeding and Adverse Events in Patients with Acute Coronary Syndrome Above 75 Years of Age

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Bleeding events in patients with acute coronary syndrome (ACS) are associated with poor outcomes. Risk factors and their associations with in-hospital events in older patients with ACS are not fully understood, because older patients with ACS are often excluded from randomized controlled studies.

The authors of this article enrolled 962 patients with ACS above 75 years of age treated at a center between January 2012 and December 2016. The incidence and risk factors for in-hospital bleeding events, as well as their associations with in-hospital adverse events were evaluated.

Bleeding complications were observed in 38 patients (4.1%). The most common bleeding site was the gastrointestinal tract (52.6%). Anemia (P=0.007), renal insufficiency (P=0.019), use of positive inotropic medicines (P=0.006) and elevated leukocyte count (P=0.046) were independent predictors of in-hospital bleeding after adjustment for age, sex, atrial fibrillation history and hypertension history. In-hospital mortality (28.9% vs. 2.4%, P<0.001), stroke (5.3% vs. 0.5%, P<0.001) and the prevalence of heart failure (39.5% vs. 16.3%, P<0.001) were significantly higher in patients with than without bleeding.

The incidence of in-hospital bleeding was 4.1% in patients with ACS above 75 years of age in this cohort. Independent risk factors for in-hospital bleeding events included anemia, renal insufficiency and elevated leucocyte count. Bleeding events were strongly associated with in-hospital adverse events.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0029

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Cheng Wei, Zhaowei Zhu and Xinqun Hu et al. Incidence, Predictors and Associations Between In-Hospital Bleeding and Adverse Events in Patients with Acute Coronary Syndrome Above 75 Years of Age – The Real-World Scenario. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0029

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Predictive Value of a Combination of the Age, Creatinine and Ejection Fraction (ACEF) Score and Fibrinogen Level in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Announcing a new article publication for Cardiovascular Innovations and Applications journal. The purpose of this study was to explore whether consideration of FIB levels might improve the predictive value of the ACEF score in patients with ACS.

A total of 290 patients with ACS were enrolled in this study. The clinical characteristics and MACE were recorded. Multivariate logistic regression analysis revealed that the FIB level (odds ratio=7.798, 95%CI, 3.44–17.676, P<0.001) and SYNTAX score (odds ratio=1.034, 95%CI, 1.001–1.069, P=0.041) were independent predictors of MACE. On the basis of the regression coefficient for FIB, the ACEF-FIB was developed. The area under the ROC of the ACEF-FIB scoring system in predicting MACE after PCI was 0.753 (95%CI 0.688–0.817, P<0.001), a value greater than those for the ACEF score, SYNTAX score and Grace score (0.627, 0.637 and 0.570, respectively).

ACEF-FIB had better discrimination ability than the other risk scores, according to ROC curve analysis, net reclassification improvement and integrated discrimination improvement.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0027

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Yuhao Zhao, Zongsheng Guo and Zheng Liu et al. Predictive Value of a Combination of the Age, Creatinine and Ejection Fraction (ACEF) Score and Fibrinogen Level in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0027

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Association between Percentage of Neutrophils at Admission and in-Hospital Events in Patients 75 Years of Age or more with Acute Coronary Syndrome

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  This study evaluated the role of the neutrophil percentage (N%) at admission in predicting in-hospital major adverse cardiovascular events (MACE) in patients ≥75 years of age with acute coronary syndrome (ACS).

A total of 1189 patients above 75 years of age with ACS hospitalized at the Second Xiangya Hospital between January 2013 and December 2017 were enrolled in this retrospective study. Receiver operator characteristic curve analysis was performed to calculate the optimal N% cut-off value for patient grouping. The in-hospital MACE consisted of acute left heart failure, stroke and any cause of death. Multivariable logistic analyses were used to assess the role of N% in predicting MACE in older patients with ACS.

The patients were divided into a high N% group (N% ≥74.17%, n=396) and low N% group (N%<74.17%, n=793) according to the N% cut-off value (N%=74.17%). The rate of MACEs during hospitalization was considerably higher in the high N% group than the low N% group (27.5% vs. 9.6%, P<0.001). After adjustment for other factors, high N% remained an independent risk factor for in-hospital MACE in older patients with ACS (odds ratio 1.779, 95% confidence interval 1.091–2.901, P=0.021).

High N% at admission is an independent risk factor for in-hospital MACE in patients above 75 years of age with ACS.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0010

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Cuihong Tian, Zhaowei Zhu and Hebin Xie et al. Association between Percentage of Neutrophils at Admission and in-Hospital Events in Patients ≥75 Years of Age with Acute Coronary Syndrome. CVIA. 2023. Vol. 7(1). DOI: 10.15212/CVIA.2023.0010

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