The clinics of acute coronary syndrome

Cervellin, Gianfranco; Rastelli, Gianni

doi:10.21037/atm.2016.05.10

Cited by 34 publications

(21 citation statements)

References 64 publications

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“…Very recently, the American Heart Association (AHA) has issued a document (37) reaffirming the existence of sex-specific differences in presentation, pathophysiological mechanisms, and outcomes in patients with MI. This evidence was been then confirmed in subsequent analyses, reviewed elsewhere (38,39). Traditionally, the notion that a diagnosis of MI is less likely in women with suspected ACS has been attributed to the less frequency of typical symptoms and the lower frequency of suggestive electrocardiography findings.…”

Section: In the Edmentioning

confidence: 76%

High-sensitivity cardiac troponin testing in routine practice: economic and organizational advantages

Galli¹,

Lippi

2016

Ann. Transl. Med.

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Very seldom, if ever, a single laboratory test has provided such a paradigm shift in the managed care as cardiac troponin (cTn) testing. More than twenty years of improvements in test design and analytical features have contributed to revolutionize the clinical recommendations and guidelines, and the diagnosis of myocardial infarction (MI) is now highly dependent upon the kinetics of cTn within a suggestive clinical setting. Despite the advent of high-sensitivity cTn (HS-cTn) immunoassays has allowed a more accurate and timely diagnosis as well as a higher prognostic accuracy, the focus is now shifting on the most suitable algorithms and on a comprehensive approach to the clinical management of acute coronary syndrome (ACS). In this article we aim to discuss the implications of HS-cTn testing for ruling out and ruling in ACS. In the latter instance, main improvements are related to ACS diagnosis in women, in whom this pathology is still often underdiagnosed or misdiagnosed. A quick and accurate rule out will also regarded as a great advantage from both an organizational and economic standpoint.The advantages that will stem from this new approach have been recently assessed, and shortening of repeated testing 1 or 2 h from conventional algorithms entailing blood sampling at 3 and 6 h seems attainable. The larger benefits will definitely occur in clinical settings where the actual diagnosis rate of MI among patients with suspect ACS is lower and, consequently, the negative predictive value (NPV) of HS-cTn is the highest.

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Section: In the Edmentioning

confidence: 76%

High-sensitivity cardiac troponin testing in routine practice: economic and organizational advantages

Galli¹,

Lippi

2016

Ann. Transl. Med.

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“…Acute myocardial infarction (AMI), one of the leading causes of mortality and morbidity worldwide, is a manifestation of acute coronary syndrome (ACS) [1]. ACS is a group of clinical syndromes that include unstable angina pectoris, non-ST-segment elevation AMI (NSTEMI), STsegment elevation AMI (STEMI) and sudden death [2]. Many associated risk factors, such as age, sex, lifestyle, hypertension, diabetes, atherosclerosis, dyslipidemia and genetic factors, are significantly associated with AMI [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

LncRNA SNHG8 is identified as a key regulator of acute myocardial infarction by RNA-seq analysis

et al. 2019

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BackgroundLong noncoding RNAs (lncRNAs) are involved in numerous physiological functions. However, their mechanisms in acute myocardial infarction (AMI) are not well understood.MethodsWe performed an RNA-seq analysis to explore the molecular mechanism of AMI by constructing a lncRNA-miRNA-mRNA axis based on the ceRNA hypothesis. The target microRNA data were used to design a global AMI triple network. Thereafter, a functional enrichment analysis and clustering topological analyses were conducted by using the triple network. The expression of lncRNA SNHG8, SOCS3 and ICAM1 was measured by qRT-PCR. The prognostic values of lncRNA SNHG8, SOCS3 and ICAM1 were evaluated using a receiver operating characteristic (ROC) curve.ResultsAn AMI lncRNA-miRNA-mRNA network was constructed that included two mRNAs, one miRNA and one lncRNA. After RT-PCR validation of lncRNA SNHG8, SOCS3 and ICAM1 between the AMI and normal samples, only lncRNA SNHG8 had significant diagnostic value for further analysis. The ROC curve showed that SNHG8 presented an AUC of 0.850, while the AUC of SOCS3 was 0.633 and that of ICAM1 was 0.594. After a pairwise comparison, we found that SNHG8 was statistically significant (P SNHG8-ICAM1 = 0.002; P SNHG8-SOCS3 = 0.031). The results of a functional enrichment analysis of the interacting genes and microRNAs showed that the shared lncRNA SNHG8 may be a new factor in AMI.ConclusionsOur investigation of the lncRNA-miRNA-mRNA regulatory networks in AMI revealed a novel lncRNA, lncRNA SNHG8, as a risk factor for AMI and expanded our understanding of the mechanisms involved in the pathogenesis of AMI.

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“…It is hence reasonable that major focus should be placed to identify reliable prediction models, which may help stratify the cardiovascular and overall risk of complications and death after an ACS. The diagnostic approach to patients with ACS encompasses the evaluation of clinical signs and symptoms, electrocardiographic assessment, combined with the measurement of circulating biomarkers which may provide reliable diagnostic and prognostic information (3)(4)(5). Despite the introduction of high-sensitivity immunoassays for the measurement of cardiac troponins has virtually revolutionized the diagnostic approach to patients with suspected ACS (6,7) providing also useful valuable information for the prognosis of these patients (8), the prediction of the future risk of major adverse cardiac events (MACE) still engages the minds of many emergency physicians and cardiologists.…”

Section: Introductionmentioning

confidence: 99%

Red blood cell distribution width independently predicts medium-term mortality and major adverse cardiac events after an acute coronary syndrome

et al. 2016

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The clinics of acute coronary syndrome

Cited by 34 publications

References 64 publications

High-sensitivity cardiac troponin testing in routine practice: economic and organizational advantages

High-sensitivity cardiac troponin testing in routine practice: economic and organizational advantages

LncRNA SNHG8 is identified as a key regulator of acute myocardial infarction by RNA-seq analysis

Red blood cell distribution width independently predicts medium-term mortality and major adverse cardiac events after an acute coronary syndrome

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