BackgroundAtherosclerosis is a systemic, lipid-driven immune-inflammatory disease.MethodsWe retrospectively reviewed institutional electronic medical records to seek chest pain patients who were suspicious of acute coronary syndrome (ACS) between January 2011 and December 2013. All the patients were identified by undergoing coronary angiography. On admission white blood cell and its subtypes were measured as part of the automated complete blood count and fasting venous blood samples were obtained and analyzed for lipids profiles used automated analysis.ResultsA total of 376 consecutive patients with ACS were investigated. In the same period, 378 patients admitted with chest pain suspicious of ACS were also included in this study for control. Blood glucose, serum creatinine, white blood cell, neutrophil and monocyte were insignificantly higher in the ACS group. ACS group had higher total cholesterol and lower high density lipid-cholesterol. However, triglyceride and low density lipid-cholesterol were similar between ACS and control groups. Atherogenic index of plasma (AIP) was significantly higher in ACS group compared to control group (p = 0.029). Similarly, ACS group had higher neutrophil–lymphocyte ratio (NLR) than those in control group. In the subgroups, the NLR were significantly higher in the STEMI group (p < 0.001). However, AIP were similar between the three subgroups (p = 0.748).ConclusionsOur data firstly investigated the lipid-driven inflammatory state in acute coronary syndrome through two easily feasible parameters. There suggest that there are higher AIP and NLR in the ACS patients. Moreover, ACS subgroups are all lipid-driven states, but inflammation levels are different in the entity ACS subgroups.

Background:Most of acute coronary syndromes (ACS) were receiving intervention treatment a high overall rate of coronary angiography in the modern medical practice.Consequently, we conduct a review to determine the heart rate (HR) on the prognosis of ACS in the coronary intervention era.Methods:PubMed, EMBASE, MEDLINE, and the Cochrane Library was systematically searched up to May 2016 using the search terms “heart rate,” “acute coronary syndrome,” “acute myocardial infarction,” “ST elevation myocardial infarction,” “non-ST-segment elevation.” The outcome of interest was all-cause mortality. All analyses were performed using Review Manager.Results:Database searches retrieved 2324 citations. Eleven studies enrolling 156,374 patients were included. In-hospital mortality was significantly higher in the elevated HR group compared to the lower HR group (pooled RR 2.04, 95%CI 1.80–2.30, P < 0.0001). Individuals with elevated admission HR had increased risk of long-term mortality (Pooled RR = 1.63, 95%CI 1.27–2.10, P = 0.008) compared to lower admission HR. The pooled results showed elevated discharge and resting HR were related to increased mortality of patients with ACS (pooled RR 1.88, 95% CI 1.02–3.47, P = 0.04; pooled RR 2.14, 95%CI 1.37–3.33, P < 0.0001, respectively).Conclusion:Elevated HR may increase the mortality of ACS patients in the percutaneous coronary intervention era.

BackgroundThere is little information about the prognostic value of double product (DP) for acute coronary syndrome (ACS) patients treated with percutaneous coronary intervention (PCI). The aim of this study was to investigate whether DP reflects the predictive power of heart rate (HR) or systolic blood pressure (SBP) in ACS patients treated with PCI.MethodsA total of 7590 ACS patients who had undergone PCI, free from cardiac shock, were included. The follow-up duration was two years. The main adverse cardiovascular events (MACEs) included all-cause death, recurrent myocardial infarction and stroke.ResultsIn the unadjusted model, significantly higher rates of MACEs were recorded in the high DP group (relative risk 1.41, 95%CI 1.08 to 1.83, p = 0.012). However, in the full adjusted models, after including HR and SBP, the predictive value of DP was not significant (relative risk 0.86, 95%CI 0.55 to1.33, p = 0.499). The predictive value of HR for MACEs was statistically significant (relative risk 1.74, 95% CI 1.33–2.28, p < 0.001). It was worth noting that the history of hypertension was strongly associated with MACEs (relative risk 1.53, 95% CI 1.11–2.11, p = 0.009).ConclusionHigh DP is associated with MACEs for ACS patients treated with PCI. However, the predictive value of DP weakened when adjusted for HR. Therefore, we have shown that DP may reflect the predictive power of HR for ACS patients treated with PCI.Electronic supplementary materialThe online version of this article (10.1186/s12872-017-0714-z) contains supplementary material, which is available to authorized users.

Background Effect of antecedent hypertension on mortality after acute coronary syndromes (ACS) in the percutaneous coronary intervention (PCI) era is less clear. The aim of this meta-analysis was to assess effect of antecedent hypertension on short and long-term mortality after ACS in the coronary intervention era.Methods PubMed, Medline, EMBASE and the Cochrane library were systematically searched up to April 2023. Ten studies with total of 64, 989 of patients met the inclusion criteria. The outcomes of interest were (i) all-cause in-hospital mortality; (ii) long-term all- cause mortality.Results No significant difference was observed in in-hospital mortality between antecedent hypertension group and non-antecedent hypertension with pooled odds ratio (OR): 1.07, 95% confidence interval (CI): 0.79–1.45; I2 = 82%, the same as ST elevation myocardial infarction (STEMI) group (pooled OR: 1.01, 95% CI: 0.73– 1.39; I2 = 66%). However, result was statistically significant for non-ST elevation myocardial infarction (NSTE-ACS) patients, with pooled OR: 0.67, 95% CI: 0.55–0.82; p = 0.0001, I2 = 0%. Antecedent hypertension was related to increased long-term mortality of patients with ACS (pooled OR 1.28, 95% CI 1.16–1.40, p = 0.0001; I2 = 0%), the same as STEMI subgroups.Conclusion In PCI era antecedent hypertension was associated with higher long-term mortality in ACS patients, but no significant difference was observed in in-hospital mortality between hypertension and non- hypertension. However, for NSTE-ACS patients’ antecedent hypertension may be a protective factor related to in- hospital mortality.