Prognostic Value of Serum Amyloid A Protein in Patients With Acute Myocardial Infarction

Katayama, Toshiro; Nakashima, Hiroshi; Takagi, Chisa; Honda, Yukiharu; Suzuki, Shin; Iwasaki, Yoshihiro; Yano, Katsusuke

doi:10.1253/circj.69.1186

Cited by 27 publications

(23 citation statements)

References 30 publications

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“…19,20 Previous studies have demonstrated that CRP, an acute phase representative protein, is associated with various complications, including cardiac events 21 and left ventricular dysfunction 22 in AMI. We have reported that acutephase plasma SAA concentrations after successful direct PCI are closely related to major adverse complications, including mortality 23 and the present study demonstrates that SAA is a predictor of SAT after primary stenting.…”

Section: Discussionsupporting

confidence: 68%

Predictors of Sub-Acute Stent Thrombosis in Acute Myocardial Infarction Patients Following Primary Coronary Stenting With Bare Metal Stent

Katayama

Nakashima

Takagi

et al. 2006

Circ J

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Section: Discussionsupporting

confidence: 68%

Predictors of Sub-Acute Stent Thrombosis in Acute Myocardial Infarction Patients Following Primary Coronary Stenting With Bare Metal Stent

Katayama

Nakashima

Takagi

et al. 2006

Circ J

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“…18) When in vivo inflammation occurs, synthesis of SAA, as well as CRP, in the liver is accelerated by inflammatory cytokines. We have reported that acute-phase elevated plasma SAA concentrations, like CRP concentration, 11) might be suggestive of a poor prognosis in patients with AMI. In this study, the value of hs-CRP on admission and 24 hours after onset, and SAA were significantly higher in the smoking group than in the nonsmoking group.…”

Section: Discussionmentioning

confidence: 92%

“…[6][7][8] On the other hand, there is now increasing evidence that acute coronary syndrome (ACS) is an inflammatory condition. [9][10][11] It is likely that smoking induces inflammation, an atherogenic lipid profile, and a propensity to thrombosis, thereby promoting the development of coronary atherothrombosis. However, it is uncertain if chronic inflammation, which is provoked by smoking, plays an etiologic role in 'smoker's paradox'.…”

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confidence: 99%

<b>The Etiology of ‘Smoker’s Paradox’ in Acute Myocardial Infarction With Special Emphasis on the Association With Inflammation</b>

Katayama¹,

Iwasaki²,

Sakoda³

et al. 2008

Int. Heart J.

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SUMMARYDespite increased risk for coronary artery disease and acute myocardial infarction (AMI), prior studies have found that smokers with AMI have lower mortality rates than nonsmokers, a phenomenon often termed 'smoker's paradox'. The present study was designed to examine the etiology of 'smoker's paradox', especially with respect to the association with inflammation.The subjects included 528 consecutive AMI patients who were admitted within 24 hours of onset and underwent successful coronary intervention. Of the 528 subjects, 232 (44%) were smokers.The cardiac mortality rates over a 6 month period was significantly lower in the smoking group than the nonsmoking group (3% versus 9%, P = 0.01). There were significantly more male patients in the smoking group, and the smoking group was significantly younger than the nonsmoking group (P < 0.0001). The value of high sensitivity C-reactive protein (hs-CRP) on admission and 24 hours after onset, and serum amyloid A protein (SAA) were significantly higher, and acute phase BNP was significantly lower (hs-CRP on admission 1.36 ± 1.03 mg/dL versus 0.75 ± 0.82 mg/dL, P = 0.02, hs-CRP at 24 hours 3.86 ± 4.32 mg/dL versus 2.90 ± 3.46 mg/dL, P = 0.008, SAA; 288 ± 392 µg/dL versus 176 ± 206 µg/dL, P < 0.05, BNP; 248 ± 342 pg/mL versus 444 ± 496 pg/mL, P = 0.0002) in the smoking group than in the nonsmoking group. The early ST-segment resolution rate was higher in the smoking group compared with the nonsmoking group (80% versus 66%, P = 0.003).The reason why smokers with AMI have lower mortality rates than nonsmokers, the so-called 'smoker's paradox', is believed to be because smoking induces inflammation and smokers may have less damage to microvascular function after primary percutaneous coronary intervention. (Int Heart J 2008; 49: 13-24) Key words: Myocardial infarction, Smoking, Inflammation EVEN though many epidemiologic studies have shown that cigarette smoking is associated with higher rates of myocardial infarction and death from coronary From the

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“…As for SAA, we reported that acute-phase plasma SAA concentrations after successful direct PCI are closely related to major adverse complications, including mortality. 23 However, the clinical implication of the relationship between inflammation and CR in AMI patients is unknown. The present study demonstrated a significant association between the SAA level in the acute phase of AMI and CR.…”

Section: Discussionmentioning

confidence: 99%

Serum Amyloid A Protein as a Predictor of Cardiac Rupture in Acute Myocardial Infarction Patients Following Primary Coronary Angioplasty

Katayama

Nakashima

Takagi

et al. 2006

Circ J

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Background The predictors of cardiac rupture (CR) in patients with acute myocardial infarction (AMI) treated with successful primary coronary angioplasty have not been identified. Methods and ResultsOf 433 consecutive AMI subjects who underwent reperfusion by primary coronary angioplasty within 24 h of onset, CR occurred in 11 (2.5%), free wall rupture in 9, and ventricular septal perforation in 2. Rates of females, diabetes mellitus and anterior infarction were higher in the group of CR patients than in the others (p<0.05). There were no significant differences between the 2 groups in terms of left ventricular (LV) function soon after recanalization, such as LV ejection fraction, regional wall motion, or end-diastolic volume index. Plasma levels of both high-sensitivity C-reactive protein (hsCRP) and serum amyloid-A protein (SAA) were significantly higher in the CR patients than in the others (hsCRP: 6.7±6.7mg/dl vs 3.3±3.8 mg/dl, p=0.007; SAA: 699±812 g/dl vs 208±273 g/dl, p<0.0001). Multivariate analysis identified SAA as an independent predictor of CR (risk ratio: 8.8, 95% confidence interval: 1.7-25.6, p<0.05). Conclusions In patients with AMI treated with primary coronary angioplasty, inflammation may be closely related to CR, for which SAA is a useful predictor. (Circ J 2006; 70: 530 -535)

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Prognostic Value of Serum Amyloid A Protein in Patients With Acute Myocardial Infarction

Cited by 27 publications

References 30 publications

Predictors of Sub-Acute Stent Thrombosis in Acute Myocardial Infarction Patients Following Primary Coronary Stenting With Bare Metal Stent

Predictors of Sub-Acute Stent Thrombosis in Acute Myocardial Infarction Patients Following Primary Coronary Stenting With Bare Metal Stent

<b>The Etiology of ‘Smoker’s Paradox’ in Acute Myocardial Infarction With Special Emphasis on the Association With Inflammation</b>

Serum Amyloid A Protein as a Predictor of Cardiac Rupture in Acute Myocardial Infarction Patients Following Primary Coronary Angioplasty

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Prognostic Value of Serum Amyloid A Protein in Patients With Acute Myocardial Infarction

Cited by 27 publications

References 30 publications

Predictors of Sub-Acute Stent Thrombosis in Acute Myocardial Infarction Patients Following Primary Coronary Stenting With Bare Metal Stent

Predictors of Sub-Acute Stent Thrombosis in Acute Myocardial Infarction Patients Following Primary Coronary Stenting With Bare Metal Stent

<b>The Etiology of &lsquo;Smoker&rsquo;s Paradox&rsquo; in Acute Myocardial Infarction With Special Emphasis on the Association With Inflammation</b>

Serum Amyloid A Protein as a Predictor of Cardiac Rupture in Acute Myocardial Infarction Patients Following Primary Coronary Angioplasty

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<b>The Etiology of ‘Smoker’s Paradox’ in Acute Myocardial Infarction With Special Emphasis on the Association With Inflammation</b>