BackgroundAlanine transaminase (ALT) and aspartate aminotransferase (AST) are referred to as liver transaminases. Although used routinely in clinical practice for decades, their role as predictors of mortality has not been examined until recently. We studied the predictive value of these serum transaminases in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).MethodsWe analyzed records of 2417 consecutive STEMI patients with no preexisting liver disease who were treated with primary PCI at the Cardiovascular Center in the First Hospital of Jilin University. The outcomes measured were all-cause mortality at the first month and at 2 years. The relationship between the baseline serum transaminase levels and primary outcome was determined.ResultsWe found a significant correlation between elevated liver transaminases and the Killip classification (P < 0.001 for ALT; P < 0.001 for AST), cardiac troponin I (P = 0.002 for ALT; P < 0.001 for AST), infarct-related coronary artery (P = 0.036 for ALT; P = 0.011 for AST), and pre-thrombolysis-in-myocardial-infarction (pre-TIMI) flow (P < 0.001 for ALT and AST). The serum level of ALT and AST were high along with the increasing of the grade of Killip classification. The primary infarct-related coronary artery in patients with ALT ≥95th percentage was left anterior descending artery (56%), followed by right coronary artery (36%). The OR for all-cause mortality at 2 years for participants with ALT ≥95th percentage was 5.370 (95% CI: 2.899–9.948), 7.034 (95% CI: 3.718–13.307) after adjustment for age and gender and 1.051 (95% CI: 0.302–3.652) after adjustment for all covariables. The OR for all-cause mortality at 2 years for participants with AST ≥95th percentage was 5.370 (95% CI 2.899–9.948) and 5.699 (95% CI 3.030–10.718) after adjustment for age and gender and 1.796 (95% CI: 0.588–5.481) after adjustment for all covariables. ALT (HR 1.004, 95% CI 1.001–1.006, P = 0.010) and AST (HR 0.999, 95% CI 0.998–1.000, P = 0.030) were associated with early all-cause mortality in patients with STEMI treated with PCI but not at 2 years post-procedure, unless for AST and ALT levels ≥95th percentage. Moreover, short- and long-term outcomes were significantly worse when both AST and ALT levels ≥95th percentage (P < 0.001).ConclusionsSerum transaminases ≥95th percentage were associated with a significantly increased incidence of short- and long-term all-cause mortality.Trial registrationRegistration number: ChiCTR-EPC-16008199, 31 March 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-017-0485-6) contains supplementary material, which is available to authorized users.

The administration of intravenous vitamin C (IV‐VC) in treating patients with coronavirus disease 2019 (COVID‐19) is still highly controversial. There have been no previous studies on the effect of IV‐VC on the severity and mortality of COVID‐19. Hence, we conducted a systematic review and meta‐analysis to compare the disease severity and mortality in patients with COVID‐19 who promptly received IV‐VC treatment vs those who did not. We performed a comprehensive systematic search of seven health science databases, including PubMed, Embase, Cochrane Library, MEDLINE, Web of Science, China National Knowledge Infrastructure, and Wanfang Data, up to June 23, 2021. We identified a total of seven related articles, which were included in this study. This meta‐analysis showed that IV‐VC treatment did not affect disease severity compared with placebo treatment or usual care (odds ratio [OR], 0.70; 95% CI, 0.45 to 1.07; P = 0.10). In addition, no statistically significant difference in mortality was observed between patients who received IV‐VC treatment and those who did not (OR, 0.64; 95% CI, 0.41 to 1.00; P = 0.05). Moreover, the adjusted meta‐analysis revealed that the use of IV‐VC did not influence disease severity (OR, 0.67; 95% CI, 0.34 to 1.31; P = 0.242) or mortality (OR, 1.02; 95% CI, 0.75 to 1.40; P = 0.877) in comparison with a control group. The results of this meta‐analysis demonstrated that short‐term IV‐VC treatment did not reduce the risk of severity and mortality in patients with COVID‐19.

BackgroundThe incidence of young coronary heart disease (CHD, ≤45 years) in China is increasing. Secondary prevention to counter this trend is an important contemporary public health issure.MethodsA total of 5288 patients (≤45 years) diagnosed with CHD and hospitalized at the Chinese PLA General Hospital and Anzhen Hospital, both in Beijing, were enrolled after satisfying the inclusion criteria.ResultsYoung CHD patients increased in number from 2010 to 2014, especially men. Among the studied patients, there was no significant change over those years in blood pressure, but heart rate increased significantly (P < 0.05) and body mass index showed a rising trend (P > 0.05). The incidence of hypertension increased from 40.7 to 47.5%, diabetes from 20.3 to 26.1%, and hyperlipidemia from 27.3 to 35.7% (P < 0.05). However, the incidences of smoking and drinking both trended downward (P < 0.05). The levels of total cholesterol and triglycerides also showed a downward trend (P < 0.05), as did levels of low-density lipoprotein, but not to the point of statistical significance (P > 0.05). Mortality during hospitalization decreased significantly from 2010 to 2014 (P < 0.05), but there was no significant improvement in the incidences of cardiac death and major adverse cardiovascular events (MACE) after 1-year follow-up (P > 0.05).ConclusionsOver the 5 years studied, the overall incidence of cardiac death and MACE for young CHD patients (≤45 years) has shown little improvement. Secondary prevention of young CHD, and its risk factors, as well as appropriate courses of medical treatment must be further elucidated.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-016-0458-1) contains supplementary material, which is available to authorized users.

Rationale:Hypereosinophilic syndrome (HES) is a rare disease characterized by hypereosinophilia and its ensuing organ damage. Cardiac involvement is divided into 3 chronological stages: an acute necrotic stage; a thrombus formation stage; and a fibrotic stage. Infiltration of the myocardium by eosinophilic cells followed by endomyocardial fibrosis is known as “Loeffler endocarditis.”Patient concerns:We report a case of a 60-year-old man diagnosed with left-sided restrictive cardiomyopathy.Diagnosis:The patient experienced heart failure with preserved ejection fraction. The cardiac MRI showed intense, linear, delayed gadolinium enhancement of the endocardium of the lateral wall of the left ventricle, and obliteration of the LV apex. He was ultimately identified as Loeffler endocarditis.Intervention:A bone marrow smear and biopsy revealed the FIP1L1-PDGFRA fusion gene was positive in 82% of segmented nucleated cells.Outcome:Our patient responded well to prednisone at 1 mg/kg/d.Lessons:HES is a rare disease that often afflicts the heart. Cardiac involvement in hypereosinophilia, especially Loeffler endocarditis, carries a poor prognosis and significant mortality. Early detection and treatment of the disease is therefore essential. Further studies are needed to ascertain therapeutic corticosteroid dosages and develop targeted gene therapies, both important steps to ameliorate the effects of Loeffler endocarditis and improve patient outcomes.