Novel Functional Risk Factors for the Prediction of Cardiovascular Events in Vulnerable Patients Following Acute Coronary Syndrome

Reriani, Martin; Flammer, Andreas J.; Jama, Abdi A.; Lerman, Lilach O.; Lerman, Amir

doi:10.1253/circj.cj-12-0248

Cited by 46 publications

(43 citation statements)

References 82 publications

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“…Inflammation underlies lesion evolution at all stages, from plaque establishment to rupture and thrombosis (13)(14)(15). ACSs (UA, AMI and ischemic sudden death) may result from the disruption of atherosclerotic plaques, leading to coronary thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Clinical implications of tenascin-C and OX40 ligand in patients with acute coronary syndrome

Yang

Ren

2013

Biomedical Reports

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Abstract. Acute coronary syndrome (ACS) typically occurs when coronary artery disease results in the obstruction of the coronary arteries. Tenascin-C (TNC) and OX40 ligand (OX40L) were shown to be involved in the pathogenesis of atherosclerosis. In this study, 50 healthy controls and 170 patients, including 50 patients with stable angina (SA), 70 with unstable angina and 50 with acute myocardial infarction, were evaluated to assess serum TNC and plasma OX40L levels. The serum TNC levels were measured by a quantitative automated particle-enhanced immunonephelometric assay. ELISA was used to determine the expression levels of OX40L. All the coronary stenoses with a ≥30% diameter reduction were assessed by angiographic coronary stenosis morphology. The patients with ACS exhibited a significant increase in TNC expression levels (39.39±19.80 ng/ml) compared to the levels in the control and SA groups (28.65±12.32 ng̸ml, P<0.01 and 31.22±18.92 ng/ml, P<0.05, respectively). The levels of OX40L were also found to be higher in patients with ACS (38.59±15.76 ng̸ml) compared to those in the control and SA groups (19.42±11.19 ng̸ml, P<0.001 and 21.52±10.30 ng/ml, P<0.001, respectively). The TNC and OX40L levels were positively correlated with each other (r 1 =0.68; P<0.001) and with fibrinogen levels (r 3 =0.76 and r 4 =0.45, respectively; P<0.001). A positive correlation was also observed between the expression of TNC and OX40L and complex coronary stenosis (r 5 =0.69 and r 6 =0.55, respectively; P<0.001). We concluded that TNC and OX40L may act synergistically in coronary plaque formation and may be also be involved in the pathogenesis of coronary lesions. Patients with ACS exhibited increased TNC and OX40L expression levels, which may have created a prothrombotic milieu, aggravating the development of atherosclerosis and the instability of atherosclerotic plaques. Therefore, the expression of TNC and OX40L may be a valuable marker for predicting the severity of ACS.

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Section: Discussionmentioning

confidence: 99%

Clinical implications of tenascin-C and OX40 ligand in patients with acute coronary syndrome

Yang

Ren

2013

Biomedical Reports

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“…33, 34 In the present study, sleep quality was evaluated on actigraphy; and probable SDB defined on actigraphy (sleep efficiency <70% and/or total sleep time <5h), 25 which is a predictor of SDB including OSA, did not significantly differ between the high-and low-ADMA groups. In addition, the associations of UME with NH and non-dipper in both ADMA groups were consistent in the models, including probable SDB as a covariate (data not shown).…”

Section: Resultsmentioning

confidence: 72%

Asymmetric Dimethylarginine Attenuates the Association of Melatonin Secretion With Night-Time Blood Pressure and Dipping in Elderly Individuals

Obayashi

Saeki

Kurumatani

2014

Circ J

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2908OBAYASHI K et al. Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jp the bioavailability of eNO. This modified amino acid is derived from hydrolysis of post-translationally methylated proteins and is partly cleared by renal excretion. 16,17 ADMA is elevated to levels that can inhibit NOS activity in individuals without renal failure. 18 ADMA may increase as a result of the reduced activity of dimethylarginine dimethylaminohydrolase (DDAH), which hydrolyses ADMA to dimethylamine and l-citrulline. DDAH may be inactivated by atherosclerotic risk factors, including aging, diabetes, and oxidative stress. 19 We hypothesized that melatonin secretion may be associated with NH and with non-dipper in individuals with low serum ADMA but that the association of melatonin with night-time BP and dipping may be attenuated in those with high serum ADMA. Associations between ADMA, melatonin secretion, and ambulatory BP (ABP), however, have not been explored in humans. To determine these associations, we conducted a cross-sectional study that included 852 community-based elderly individuals. t has been recognized that night-time blood pressure (BP) and nocturnal BP fall (dipping) are better predictors of cardiovascular disease and mortality than daytime and office BP. 1-3 Increased night-time BP (nocturnal hypertension, NH) and the lack of dipping (non-dipper) are both related to a high risk of target organ damage and cardiovascular events. 1,4,5Melatonin secretion follows a circadian rhythm, with almost all production at night, and its receptors have been found in central and peripheral tissues, including endothelial cells. 6-8 Melatonin increases endothelium-derived nitric oxide (eNO) that decreases vascular tone and arterial BP. 9,10 Several clinical trials have suggested that oral melatonin lowers night-time BP. 11,12 In addition, endogenous melatonin, which is present at considerably lower levels than pharmacological melatonin, is associated with non-dipper and NH. 13-15 Thus, increased eNO induced by melatonin can partially explain the enhanced decrease in night-time BP and increase in dipping.Asymmetric dimethylarginine (ADMA) is a major endogenous competitive inhibitor of NO synthase (NOS) that controls

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“…The presence or absence of f-QRS in patients with MI in the ECG before and after PCI was previously studied. It was noted that the f-QRS may be useful in identifying patients with a higher risk of ischaemic areas or myocardial necrosis [12,13].…”

Section: Resultsmentioning

confidence: 99%

Fragmentation of the QRS complex in patients with acute coronary syndrome treated invasively

et al. 2016

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A b s t r a c tBackground: Previous studies showed that the presence of fragmented QRS (f-QRS) in patients with acute coronary syndrome (ACS), who underwent complete revascularisation, is associated with worse prognosis and the possibility of arrhythmia occurrence. Aim:To assess the prognostic value of f-QRS in patients with ACS and complete revascularisation, in the context of cardiac arrhythmias. Methods:We analysed 124 consecutive patients (66.1% males; mean age 62.38 ± 11.0 years) with ACS (STEMI 49%) treated invasively. Based on electrocardiogram (ECG) record, performed during the admission to the clinic, after the complete revascularisation (TIMI = 3) and during discharging from hospital (4 th -5 th days after ACS), we classified QRS as f-QRS based on generally accepted criteria (QRS < 120 ms, which included an additional R wave [R']) or notching in the nadir of the S wave, or > 1 R' (fragmentation) in two contiguous leads, corresponding to a major coronary artery territory. 24-h Holter ECG recording was performed on the fifth day after ACS to assess the frequency of conduction disturbances and others arrhythmias.Results: There were no statistically significant differences between patients with and without f-QRS during hospitalisation. In the patients with f-QRS there were no statistically significant conduction disturbances and other arrhythmias compared to patients without f-QRS at discharge. Conclusions:In the patients with ACS, who underwent successful revascularisation (TIMI = 3), the presence of f-QRS is not correlated with a higher incidence of arrhythmias compared to patients without f-QRS in short-term follow-up.

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Novel Functional Risk Factors for the Prediction of Cardiovascular Events in Vulnerable Patients Following Acute Coronary Syndrome

Cited by 46 publications

References 82 publications

Clinical implications of tenascin-C and OX40 ligand in patients with acute coronary syndrome

Clinical implications of tenascin-C and OX40 ligand in patients with acute coronary syndrome

Asymmetric Dimethylarginine Attenuates the Association of Melatonin Secretion With Night-Time Blood Pressure and Dipping in Elderly Individuals

Fragmentation of the QRS complex in patients with acute coronary syndrome treated invasively

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