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Journal of Korean Medical Science Apr 2023Lipoprotein(a) is a known independent risk factor for atherosclerotic cardiovascular disease. However, the prognostic impact of the baseline lipoprotein(a) levels on...
BACKGROUND
Lipoprotein(a) is a known independent risk factor for atherosclerotic cardiovascular disease. However, the prognostic impact of the baseline lipoprotein(a) levels on long-term clinical outcomes among patients with acute myocardial infarction remain unclear.
METHODS
We analyzed 1,908 patients with acute myocardial infarction from November 2011 to October 2015 from a single center in Korea. They were divided into 3 groups according to their baseline lipoprotein(a) levels: groups I (< 30 mg/dL, n = 1,388), II (30-49 mg/dL, n = 263), and III (≥50 mg/dL, n = 257). Three-point major adverse cardiovascular events (a composite of nonfatal myocardial infarction, nonfatal stroke, and cardiac death) at 3 years were compared among the 3 groups.
RESULTS
The patients were followed for 1094.0 (interquartile range, 1,033.8-1,095.0) days, during which a total of 326 (17.1%) three-point major adverse cardiovascular events occurred. Group III had higher rates of three-point major adverse cardiovascular events compared with Group I (23.0% vs. 15.7%; log-rank = 0.009). In the subgroup analysis, group III had higher rates of three-point major adverse cardiovascular events compared with group I in patients with non-ST-segment elevation myocardial infarction (27.0% vs. 17.1%; log-rank = 0.006), but not in patients with ST-segment elevation myocardial infarction (14.4% vs. 13.3%; log-rank = 0.597). However, in multivariable Cox time-to-event models, baseline lipoprotein(a) levels were not associated with an increased incidence of three-point major adverse cardiovascular events, regardless of the type of acute myocardial infarction. Sensitivity analyses in diverse subgroups showed similar findings to those of the main analysis.
CONCLUSION
Baseline lipoprotein(a) levels in Korean patients with acute myocardial infarction were not independently associated with increased major adverse cardiovascular events at 3 years.
Topics: Humans; Lipoprotein(a); Myocardial Infarction; Prognosis; ST Elevation Myocardial Infarction; Risk Factors; Treatment Outcome
PubMed: 37012687
DOI: 10.3346/jkms.2023.38.e102 -
Journal of the American College of... Mar 2020
Topics: Heart Injuries; Humans; Myocardial Infarction; Prognosis; Troponin; Young Adult
PubMed: 32138960
DOI: 10.1016/j.jacc.2020.01.004 -
BMC Cardiovascular Disorders Mar 2023Despite improvements in the treatment and prevention of cardiovascular disease since the 1960s, the incidence of cardiovascular diseases among young people has remained...
BACKGROUND
Despite improvements in the treatment and prevention of cardiovascular disease since the 1960s, the incidence of cardiovascular diseases among young people has remained the same for many years. This study aimed to compare the clinical and psychosocial attributes of young persons affected by myocardial infarction under the age of 50 years compared to middle-aged myocardial infarction patients 51-65 years old.
METHODS
Data from patients with a documented STEMI or NSTEMI elevated acute myocardial infarction in the age groups up to 65 years, were collected from cardiology clinics at three hospitals in southeast Sweden. The Stressheart study comprised a total of 213 acute myocardial infarction patients, of which n = 33 (15.5%) were under 50 years of age and n = 180 (84.5%) were middle-aged, (51-65 years). These acute myocardial infarction patients filled in a questionnaire at discharge from the hospital and further information through documentation of data in their medical records.
RESULTS
Blood pressure was significantly higher in young compared to middle-aged patients. For diastolic blood pressure (p = 0.003), systolic blood pressure (p = 0.028), and mean arterial pressure (p = 0.005). Young AMI patients had a higher (p = 0.030) body mass index (BMI) than the middle-aged. Young AMI patients were reported to be more stressed (p = 0.042), had more frequently experienced a serious life event the previous year (p = 0.029), and felt less energetic (p = 0.044) than middle-aged AMI patients.
CONCLUSIONS
This study revealed that persons under the age of 50 affected by acute myocardial infarction exhibit traditional cardiovascular risk factors like high blood pressure, and higher BMI, and were more exposed to some psychosocial risk factors. The risk profile of young persons under age 50 affected by AMI was in these respects more exaugurated than for middle-aged persons with AMI. This study underlines the importance of the early discovery of those at increased risk and encourages preventative actions to focus on both clinical and psychosocial risk factors.
Topics: Middle Aged; Humans; Adolescent; Aged; Myocardial Infarction; Risk Factors; Non-ST Elevated Myocardial Infarction; ST Elevation Myocardial Infarction; Sweden
PubMed: 36890430
DOI: 10.1186/s12872-023-03134-w -
International Journal of Cardiology Oct 2022Contemporary data on the epidemiology of acute myocardial infarction (AMI) in Vietnam are extremely limited.
INTRODUCTION
Contemporary data on the epidemiology of acute myocardial infarction (AMI) in Vietnam are extremely limited.
METHODS
We established population-based registries of residents from 2 provinces in a northern urban (Hai Phong), and a central rural (Thanh Hoa), province of Vietnam hospitalized with a validated first AMI in 2018. We described patient characteristics, in-hospital management and clinical complications, and estimated incidence rates of AMI in these two registries.
RESULTS
A total of 785 patients (mean age = 71.2 years, 64.7% men) were admitted to the two hospitals with a validated first AMI. Approximately 64% of the AMI cases were ST-segment-elevation AMI. Patients from Thanh Hoa compared with Hai Phong were more likely to delay seeking acute hospital care. The incidence rates (per 100,000 population) of initial AMI in Thanh Hoa and Hai Phong were 16 and 30, respectively. Most patients were treated with aspirin (Thanh Hoa: 96%; Hai Phong: 90%) and statins (both provinces: 91%) during their hospitalization. A greater proportion of patients in Hai Phong (69%) underwent percutaneous revascularization than those in Thanh Hoa (58%). The most common in-hospital complications were heart failure (both provinces:12%), cardiogenic shock (Thanh Hoa: 10%; Hai phong: 7%); and cardiac arrest (both provinces: 9%). The in-hospital case-fatality rates for patients from Thanh Hoa and Hai Phong were 6.8% and 3.8%, respectively.
CONCLUSIONS
The incidence and hospital case-fatality rates of AMI were low in two Vietnamese provinces. Extent of pre-hospital delay and in-hospital use of evidence-based therapies were suboptimal, being more prominent in the rural province.
Topics: Aged; Female; Hospital Mortality; Hospitals; Humans; Male; Myocardial Infarction; ST Elevation Myocardial Infarction; Shock, Cardiogenic; Vietnam
PubMed: 35716944
DOI: 10.1016/j.ijcard.2022.06.044 -
American Journal of Preventive Medicine Oct 2021Cross-sectional analyses have suggested that e-cigarette use, independent of combustible cigarette use, elevates the risk of myocardial infarction. Previous researchers...
INTRODUCTION
Cross-sectional analyses have suggested that e-cigarette use, independent of combustible cigarette use, elevates the risk of myocardial infarction. Previous researchers confused their own models' assumptions that these risks were independent with the idea that their analyses validated the presence of independent risks. This study avoids this pitfall.
METHODS
Cross-sectional analyses of the 2014-2019 National Health Interview Surveys (N=175,546) were conducted in 2020.
RESULTS
Logistic regressions found that e-cigarette use was associated with having had a myocardial infarction, but this association significantly varied on the basis of one's smoking history. With a host of demographic and clinical variables controlled, e-cigarette use was associated with lifetime myocardial infarction occurrence only among current smokers. A counterfactual analysis first removed all (current or former) e-cigarette‒using respondents who had suffered a myocardial infarction without a history of smoking. The independent-effects model used in previous research misleadingly indicated that daily vaping increases never smokers' odds of having had a myocardial infarction by 1.55 (95% CI=1.11, 2.15), even though no such myocardial infarction sufferers remained in the analyzed data. The association between myocardial infarction and vaping daily has shown a significant annual decline (AOR=0.81, 95% CI=0.67, 0.98).
CONCLUSIONS
There is no reliable evidence that e-cigarette use is associated with ever having had a myocardial infarction among never smokers. Contrary to concerns that the harms associated with e-cigarettes are only now emerging after more years of possible product use, the only evidence of time-dependent variation in the association between e-cigarette use and myocardial infarction ran counter to this possibility. The scientific community must insist that researchers engage in accurate public communication of peer-reviewed findings.
Topics: Cross-Sectional Studies; Electronic Nicotine Delivery Systems; Humans; Myocardial Infarction; Vaping
PubMed: 34304940
DOI: 10.1016/j.amepre.2021.05.003 -
Journal of Cardiovascular Translational... Oct 2020The global incidence of coronary artery diseases (CADs), especially myocardial infarction (MI), has drastically increased in recent years. Even though the conventional... (Review)
Review
The global incidence of coronary artery diseases (CADs), especially myocardial infarction (MI), has drastically increased in recent years. Even though the conventional therapies have improved the outcomes, the post-MI complications and the increased rate of recurrence among the survivors are still alarming. Molecular events associated with the pathogenesis and the adaptive responses of the surviving myocardium are largely unknown. Focus on exosome-mediated signaling for cell-cell/matrix communications at the infarct zone reflects an emerging opportunity in cardiac regeneration. Also, cardiac tissue engineering provides promising insights for the next generation of therapeutic approaches in the management of CADs. In this article, we critically reviewed the current understanding on the biology of cardiac exosomes, therapeutic potential of exosomes, and recent developments in cardiac tissue engineering and discussed novel translational approaches based on tissue engineering and exosomes for cardiac regeneration and CADs.
Topics: Animals; Exosomes; Humans; Myocardial Infarction; Myocardium; Recovery of Function; Regeneration; Regenerative Medicine; Tissue Engineering
PubMed: 31907784
DOI: 10.1007/s12265-019-09952-8 -
Diabetes & Vascular Disease Research 2022To provide synthesized evidence on the association of diabetes with clinical outcomes of patients with acute myocardial infarction (AMI) and associated cardiogenic shock... (Meta-Analysis)
Meta-Analysis Review
To provide synthesized evidence on the association of diabetes with clinical outcomes of patients with acute myocardial infarction (AMI) and associated cardiogenic shock (CS). We analyzed observational studies on patients with AMI and CS, identified through a systematic search using PubMed and Scopus databases. The main outcome was mortality and other outcomes of interest were risk of major bleeding, re-infarction, cerebrovascular adverse events, and need for revascularization. We conducted the meta-analysis with data from 15 studies. Compared to patients without diabetes, those with diabetes had an increased risk of in-hospital mortality (OR, 1.34; 95% CI, 1.17-1.54) and cerebrovascular complications (OR, 1.28; 95% CI, 1.11-1.48). We found similar risk of major bleeding (OR, 0.68; 95% CI, 0.43-1.09), re-infarction (OR, 0.98; 95% CI, 0.48-1.98) and need for re-vascularization (OR, 0.96; 95% CI, 0.75-1.22) as well as hospital stay lengths (in days) (WMD 0.00; 95% CI, -0.27-0.28; = 4; I = 99.7%) in the two groups of patients. Patients with diabetes, acute MI and associated cardiogenic shock have increased risks of mortality and adverse cerebrovascular events than those without diabetes.
Topics: Diabetes Mellitus; Hemorrhage; Hospital Mortality; Humans; Myocardial Infarction; Shock, Cardiogenic; Treatment Outcome
PubMed: 36250870
DOI: 10.1177/14791641221132242 -
Scientific Reports Nov 2022Myocardial infarction diagnosis is a common challenge in the emergency department. In managed settings, deep learning-based models and especially convolutional deep...
Myocardial infarction diagnosis is a common challenge in the emergency department. In managed settings, deep learning-based models and especially convolutional deep models have shown promise in electrocardiogram (ECG) classification, but there is a lack of high-performing models for the diagnosis of myocardial infarction in real-world scenarios. We aimed to train and validate a deep learning model using ECGs to predict myocardial infarction in real-world emergency department patients. We studied emergency department patients in the Stockholm region between 2007 and 2016 that had an ECG obtained because of their presenting complaint. We developed a deep neural network based on convolutional layers similar to a residual network. Inputs to the model were ECG tracing, age, and sex; and outputs were the probabilities of three mutually exclusive classes: non-ST-elevation myocardial infarction (NSTEMI), ST-elevation myocardial infarction (STEMI), and control status, as registered in the SWEDEHEART and other registries. We used an ensemble of five models. Among 492,226 ECGs in 214,250 patients, 5,416 were recorded with an NSTEMI, 1,818 a STEMI, and 485,207 without a myocardial infarction. In a random test set, our model could discriminate STEMIs/NSTEMIs from controls with a C-statistic of 0.991/0.832 and had a Brier score of 0.001/0.008. The model obtained a similar performance in a temporally separated test set of the study sample, and achieved a C-statistic of 0.985 and a Brier score of 0.002 in discriminating STEMIs from controls in an external test set. We developed and validated a deep learning model with excellent performance in discriminating between control, STEMI, and NSTEMI on the presenting ECG of a real-world sample of the important population of all-comers to the emergency department. Hence, deep learning models for ECG decision support could be valuable in the emergency department.
Topics: Humans; ST Elevation Myocardial Infarction; Non-ST Elevated Myocardial Infarction; Deep Learning; Retrospective Studies; Electrocardiography; Myocardial Infarction; Emergency Service, Hospital
PubMed: 36380048
DOI: 10.1038/s41598-022-24254-x -
The Journal of Invasive Cardiology Feb 2024A 73-year-old woman with diabetes, hypertension, and non-ST elevation myocardial infarction underwent optical coherence tomography (OCT)-guided angioplasty for calcific...
A 73-year-old woman with diabetes, hypertension, and non-ST elevation myocardial infarction underwent optical coherence tomography (OCT)-guided angioplasty for calcific stenosis of the mid-left anterior descending artery (LAD) and mid-segment of a tortuous obtuse marginal (OM).
Topics: Female; Humans; Aged; Myocardial Infarction; Coronary Angiography; Non-ST Elevated Myocardial Infarction; Tomography, Optical Coherence
PubMed: 38335510
DOI: 10.25270/jic/23.00140 -
Circulation Nov 2022
Topics: Animals; Swine; Hippo Signaling Pathway; Myocardial Infarction; Arrhythmias, Cardiac; Genetic Therapy
PubMed: 36374968
DOI: 10.1161/CIRCULATIONAHA.122.059972