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Abstract:Background:To investigate the factors predicting the onset of major adverse cardiovascular events (MACEs) after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI) patients.Methods:Two hundred forty-eight STEMI patients (61.4 ± 10.8 years, 186 men) who underwent successful primary percutaneous coronary intervention were enrolled. Patients were followed-up for 1 year. Univariate, multivariate analyses, and receiver operating characteristic curve analysis were performed to determine the factors predicting MACEs.Results:There were 36 patients (14.5%) who experienced MACEs in the follow-up period. Multivariate logistic regression analysis demonstrated that hemoglobin (HgB) (odds ratio = 0.972; 95% CI, 0.948–0.998; P = 0.033), neutrophil/lymphocyte ratio (NLR) (odds ratio = 1.511; 95% CI, 1.148–1.987; P = 0.003), Global Registry of Acute Coronary Event score, and postprocedure left ventricular ejection fraction (LVEF) were independent predictors of MACEs. Further subgroup analysis showed higher NLR (>8.61), Global Registry of Acute Coronary Event score (>167) and lower HgB (<131 g/L) all show superior predictive value for patients with relatively higher LVEF (>48%); moreover, the c-statistic of NLR and HgB both exceed 0.7. However, among patients with lower LVEF (≤48%), higher NLR and lower HgB lost the ability for predicting 1 year MACEs independently. In addition, abnormally higher NLR (>8) could predict 1-month MACEs efficiently.Conclusions:In summary, among STEMI patients, elevated NLR, decreased HgB level on admission both predicted 1-year MACEs independently, especially for those with relatively preserved LVEF (>48%). Besides, abnormally higher NLR on admission should attract their attention for short-term MACEs.

Background: Naringenin, a natural resource-derived flavanone, exhibits a plethora of pharmacological properties. The present study aimed to investigate the effects of Naringenin on obesity-associated hypertension and its underlying mechanism. Methods: Obesity-associated hypertension rat model was established with a high-fat diet (HFD) and was administrated with Naringenin (25, 50, 100 mg/kg). Body and fat weight were recorded and blood pressure was measured. Serum lipid parameters (cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides), oxidative stress biomarkers (malondialdehyde (MDA), superoxide dismutase (SOD), nitrite oxide (NO), and glutathione (GSH)), and adipocytokines (leptin and adiponectin) were determined. The expressions of signal transducer and activator of transcription (STAT) 3 were determined by using Western blotting. Results: Treatment with Naringenin (100 mg/kg) reduced body and fat weight in HFD-induced rats. Besides, treatment with Naringenin (50 and 100 mg/kg) reduced blood pressure and regulated lipid parameters by decreasing cholesterol, triglycerides, and LDL and increasing HDL. Treatment with Naringenin (50 and 100 mg/kg) reduced serum MDA and NO, whereas increased serum SOD and GSH. Furthermore, Treatment with Naringenin (50 and 100 mg/kg) regulated adipocytokines and decreased the phosphorylation of STAT3. Conclusion: Naringenin ameliorates obesity-associated hypertension by regulating lipid disorder and oxidative stress.

Key Clinical MessageCommon clinical features of subacute rupture left ventricular free wall after acute ST segment elevation myocardial infarction are: (1) recurrent or persistent chest pain; (2) recurrent or persistent ST segment elevation; (3) hypotension. Integrating these signs into a syndrome can increase the clinician's awareness to the fatal complication.