Cardiology Research and Practice最新文献

{"title":"Real-World Experience with Cangrelor as Adjuvant to Percutaneous Coronary Intervention: A Single-Centre Observational Study.","authors":"Troels Thim,&nbsp;Lars Jakobsen,&nbsp;Rebekka Vibjerg Jensen,&nbsp;Nicolaj Støttrup,&nbsp;Ashkan Eftekhari,&nbsp;Erik Lerkevang Grove,&nbsp;Sanne Bøjet Larsen,&nbsp;Jacob Thorsted Sørensen,&nbsp;Steen Carstensen,&nbsp;Sahar Amiri,&nbsp;Karsten Tange Veien,&nbsp;Evald Høj Christiansen,&nbsp;Christian Juhl Terkelsen,&nbsp;Michael Maeng,&nbsp;Steen Dalby Kristensen","doi":"10.1155/2023/3197512","DOIUrl":"https://doi.org/10.1155/2023/3197512","url":null,"abstract":"<p><strong>Background: </strong>Reversible P2Y12 inhibition can be obtained with cangrelor administered intravenously. More experience with cangrelor use in acute PCI with unknown bleeding risk is needed.</p><p><strong>Objectives: </strong>To describe real-world use of cangrelor including patient and procedure characteristics and patient outcomes.</p><p><strong>Methods: </strong>We performed a single-centre, retrospective, and observational study including all patients treated with cangrelor in relation to percutaneous coronary intervention at Aarhus University Hospital during the years 2016, 2017, and 2018. We recorded procedure indication and priority, the indications for cangrelor use, and patient outcomes within the first 48 hours after initiation of cangrelor treatment.</p><p><strong>Results: </strong>We treated 991 patients with cangrelor in the study period. Of these, 869 (87.7%) had an acute procedure priority. Among acute procedures, patients were mainly treated for STEMI (<i>n</i> = 723) and the remaining were treated for cardiac arrest and acute heart failure. Use of oral P2Y12 inhibitors prior to percutaneous coronary intervention was rare. Fatal bleeding events (<i>n</i> = 6) were only observed among patients undergoing acute procedures. Stent thrombosis was observed in two patients receiving acute treatment for STEMI. Thus, cangrelor can be used in relation to PCI under acute circumstances with advantages in terms of clinical management. The benefits and risks, in terms of patient outcomes, should ideally be assessed in randomized trials.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2023 ","pages":"3197512"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10074225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Testing Enables the Diagnosis of Familial Hypercholesterolemia Underdiagnosed by Clinical Criteria: Analysis of Japanese Early-Onset Coronary Artery Disease Patients.","authors":"Hiroshi Miyama,&nbsp;Yoshinori Katsumata,&nbsp;Mizuki Momoi,&nbsp;Genki Ichihara,&nbsp;Taishi Fujisawa,&nbsp;Jin Endo,&nbsp;Takashi Kawakami,&nbsp;Masaharu Kataoka,&nbsp;Shinsuke Yuasa,&nbsp;Motoaki Sano,&nbsp;Kazuki Sato,&nbsp;Keiichi Fukuda","doi":"10.1155/2023/2236422","DOIUrl":"https://doi.org/10.1155/2023/2236422","url":null,"abstract":"<p><p>Definitive diagnosis of familial hypercholesterolemia (FH) is paramount for the risk management of patients and their relatives. The present study aimed to investigate the frequency of gene variants contributing to low-density lipoprotein cholesterol (LDL-C) metabolism and their clinical relevance in patients with early-onset coronary artery disease (EOCAD). Among 63 consecutive patients with EOCAD (men <55 years or women <65 years) who underwent percutaneous coronary intervention (PCI) from 2013 to 2019 at Keio University Hospital, 52 consented to participate in this retrospective study. Targeted sequencing of <i>LDLR</i>, <i>PCSK9</i>, <i>APOB</i>, and <i>LDLRAP1</i> was performed. Of the 52 patients enrolled (42 men; mean age: 50 ± 6 years), one (<i>LDLR</i>, c.1221_1222delCGinsT) harbored a pathogenic mutation, and one (<i>APOB</i>, c.10591A>G) harbored variants of uncertain significance. Both the patients harboring the variants were male, showing no history of diabetes mellitus or chronic kidney disease, no family history of EOCAD, and no physical findings of FH (i.e., tendon xanthomas or Achilles tendon thickening). Patients harboring the <i>LDLR</i> variant had three-vessel disease, were on a statin prescription at baseline, and had stable LDL-C levels; however, the case showed a poor response to the intensification of medication after PCI. Approximately 3.8% of patients with EOCAD harbored variants of gene related to LDL-C metabolism; there were no notable indicators in the patients' background or clinical course to diagnose FH. Given the difficulty in diagnosing FH based on clinical manifestations and family history, genetic testing could enable the identification of hidden risk factors and provide early warnings to their relatives.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2023 ","pages":"2236422"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10162874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9430167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Bovine versus Porcine Mitral Valve Replacement: A Multicenter Analysis.","authors":"M Broadwin,&nbsp;N Ramkumar,&nbsp;D J Malenka,&nbsp;R D Quinn,&nbsp;C S Ross,&nbsp;F Hirashima,&nbsp;J D Klemperer,&nbsp;R S Kramer,&nbsp;G L Sardella,&nbsp;B Westbrook,&nbsp;A W Discipio,&nbsp;A Iribarne,&nbsp;M P Robich","doi":"10.1155/2023/2111843","DOIUrl":"https://doi.org/10.1155/2023/2111843","url":null,"abstract":"<p><strong>Introduction: </strong>Recent national guidelines recommending mitral valve replacement (MVR) for severe secondary mitral regurgitation have resulted in an increased utilization of mitral bioprosthesis. There is a paucity of data on how longitudinal clinical outcomes vary by prosthesis type. We examined long-term survival and risk of reoperation between patients having bovine vs. porcine MVR. <i>Study Design</i>. A retrospective analysis of MVR or MVR + coronary artery bypass graft (CABG) from 2001 to 2017 among seven hospitals reporting to a prospectively maintained clinical registry was conducted. The analytic cohort included 1,284 patients undergoing MVR (801 bovine and 483 porcine). Baseline comorbidities were balanced using 1 : 1 propensity score matching with 432 patients in each group. The primary end point was all-cause mortality. Secondary end points included in-hospital morbidity, 30-day mortality, length of stay, and risk of reoperation.</p><p><strong>Results: </strong>In the overall cohort, patients receiving porcine valves were more likely to have diabetes (19% bovine vs. 29% porcine; <i>p</i> < 0.001), COPD (20% bovine vs. 27% porcine; <i>p</i>=0.008), dialysis or creatinine >2 mg/dL (4% bovine vs. 7% porcine; <i>p</i>=0.03), and coronary artery disease (65% bovine vs. 77% porcine; <i>p</i> < 0.001). There was no difference in stroke, acute kidney injury, mediastinitis, pneumonia, length of stay, in-hospital morbidity, or 30-day mortality. In the overall cohort, there was a difference in long-term survival (porcine HR 1.17 (95% CI: 1.00-1.37; <i>p</i>=050)). However, there was no difference in reoperation (porcine HR 0.56 (95% CI: 0.23-1.32; <i>p</i>=0.185)). In the propensity-matched cohort, patients were matched on all baseline characteristics. There was no difference in postoperative complications or in-hospital morbidity and 30-day mortality. After 1 : 1 propensity score matching, there was no difference in long-term survival (porcine HR 0.97 (95% CI: 0.81-1.17; <i>p</i>=0.756)) or risk of reoperation (porcine HR 0.54 (95% CI: 0.20-1.47; <i>p</i>=0.225)).</p><p><strong>Conclusions: </strong>In this multicenter analysis of patients undergoing bioprosthetic MVR, there was no difference in perioperative complications and risk of reoperation of long-term survival after matching.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2023 ","pages":"2111843"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9866276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Combined Heart-Kidney Transplantation in Older Recipients.","authors":"Curry Sherard,&nbsp;Vineeth Sama,&nbsp;Jennie H Kwon,&nbsp;Khaled Shorbaji,&nbsp;Lauren V Huckaby,&nbsp;Brett A Welch,&nbsp;Chakradhari Inampudi,&nbsp;Ryan J Tedford,&nbsp;Arman Kilic","doi":"10.1155/2023/4528828","DOIUrl":"https://doi.org/10.1155/2023/4528828","url":null,"abstract":"<p><strong>Objectives: </strong>The upper limit of recipient age for combined heart-kidney transplantation (HKT) remains controversial. This study evaluated the outcomes of HKT in patients aged ≥65 years.</p><p><strong>Methods: </strong>The United Network of Organ Sharing (UNOS) was used to identify patients undergoing HKT from 2005 to 2021. Patients were stratified by age at transplantation: <65 and ≥ 65 years. The primary outcome was one-year mortality. Secondary outcomes included 90-day and 5-year mortality, postoperative new-onset dialysis, postoperative stroke, acute rejection prior to discharge, and rejection within one-year of HKT. Survival was compared using Kaplan-Meier analysis, and risk adjustment for mortality was performed using Cox proportional hazards modeling.</p><p><strong>Results: </strong>HKT in recipients aged ≥65 significantly increased from 5.6% of all recipients in 2005 to 23.7% in 2021 (<i>p</i>=0.002). Of 2,022 HKT patients in the study period, 372 (18.40%) were aged ≥65. Older recipients were more likely to be male and white, and fewer required dialysis prior to HKT. There were no differences between cohorts in unadjusted 90-day, 1-year, or 5-year survival in Kaplan-Meier analysis. These findings persisted after risk-adjustment, with an adjusted hazard for one-year mortality for age ≥65 of 0.91 (95% CI (0.63-1.29), <i>p</i>=0.572). As a continuous variable, increasing age was not associated with one-year mortality (HR 1.01 (95% CI (1.00-1.02), <i>p</i>=0.236) per year). Patients aged ≥65 more frequently required new-onset dialysis prior to discharge (11.56% vs. 7.82%, <i>p</i>=0.051). Stroke and rejection rates were comparable.</p><p><strong>Conclusion: </strong>Combined HKT is increasing in older recipients, and advanced age ≥65 should not preclude HKT.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2023 ","pages":"4528828"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10121291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Myocardial Blood Flow and Resistance Using 4D-Flow Cardiac Magnetic Resonance Imaging.","authors":"Rebecca C Gosling,&nbsp;Gareth Williams,&nbsp;Abdulaziz Al Baraikan,&nbsp;Samer Alabed,&nbsp;Eylem Levelt,&nbsp;Amrit Chowdhary,&nbsp;Peter P Swoboda,&nbsp;Ian Halliday,&nbsp;D Rodney Hose,&nbsp;Julian P Gunn,&nbsp;John P Greenwood,&nbsp;Sven Plein,&nbsp;Andrew J Swift,&nbsp;James M Wild,&nbsp;Pankaj Garg,&nbsp;Paul D Morris","doi":"10.1155/2023/3875924","DOIUrl":"https://doi.org/10.1155/2023/3875924","url":null,"abstract":"<p><strong>Background: </strong>Ischaemia with nonobstructive coronary arteries is most commonly caused by coronary microvascular dysfunction but remains difficult to diagnose without invasive testing. Myocardial blood flow (MBF) can be quantified noninvasively on stress perfusion cardiac magnetic resonance (CMR) or positron emission tomography but neither is routinely used in clinical practice due to practical and technical constraints. Quantification of coronary sinus (CS) flow may represent a simpler method for CMR MBF quantification. 4D flow CMR offers comprehensive intracardiac and transvalvular flow quantification. However, it is feasibility to quantify MBF remains unknown.</p><p><strong>Methods: </strong>Patients with acute myocardial infarction (MI) and healthy volunteers underwent CMR. The CS contours were traced from the 2-chamber view. A reformatted phase contrast plane was generated through the CS, and flow was quantified using 4D flow CMR over the cardiac cycle and normalised for myocardial mass. MBF and resistance (MyoR) was determined in ten healthy volunteers, ten patients with myocardial infarction (MI) without microvascular obstruction (MVO), and ten with known MVO.</p><p><strong>Results: </strong>MBF was quantified in all 30 subjects. MBF was highest in healthy controls (123.8 ± 48.4 mL/min), significantly lower in those with MI (85.7 ± 30.5 mL/min), and even lower in those with MI and MVO (67.9 ± 29.2 mL/min/) (<i>P</i> < 0.01 for both differences). Compared with healthy controls, MyoR was higher in those with MI and even higher in those with MI and MVO (0.79 (±0.35) versus 1.10 (±0.50) versus 1.50 (±0.69), <i>P</i>=0.02).</p><p><strong>Conclusions: </strong>MBF and MyoR can be quantified from 4D flow CMR. Resting MBF was reduced in patients with MI and MVO.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2023 ","pages":"3875924"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9911256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9112443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recombinant Adenovirus siRNA Knocking Down the Ndufs4 Gene Alleviates Myocardial Apoptosis Induced by Oxidative Stress Injury.","authors":"Beibei Wang,&nbsp;Jinsheng Zhang,&nbsp;Aijun Xu","doi":"10.1155/2023/8141129","DOIUrl":"https://doi.org/10.1155/2023/8141129","url":null,"abstract":"<p><p>Oxidative stress results in myocardial cell apoptosis and even life-threatening heart failure in myocardial ischemia-reperfusion injury. Specific blocking of the complex I could reduce cell apoptosis. Ndufs4 is a nuclear-encoded subunit of the mitochondrial complex I and participates in the electron transport chain. In this study, we designed and synthesized siRNA sequences knocking down the rat Ndufs4 gene, constructed recombinant adenovirus Ndufs4 siRNA (Ad-Ndufs4 siRNA), and primarily verified the role of Ndufs4 in oxidative stress injury. The results showed that the adenovirus infection rate was about 90%, and Ndufs4 mRNA and protein were decreased by 76.7% and 64.9%, respectively. Furthermore, the flow cytometry assay indicated that the cell apoptosis rate of the Ndufs4 siRNA group was significantly decreased as compared with the H₂O₂-treated group. In conclusion, we successfully constructed Ndufs4 siRNA recombinant adenovirus; furthermore, the downexpression of the Ndufs4 gene may alleviate H₂O₂-induced H9c2 cell apoptosis.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2023 ","pages":"8141129"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9229248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retracted: The Long-Term Change of Arrhythmias after Transcatheter Closure of Perimembranous Ventricular Septal Defects.","authors":"Cardiology Research And Practice","doi":"10.1155/2023/9898161","DOIUrl":"https://doi.org/10.1155/2023/9898161","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1155/2021/1625915.].</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2023 ","pages":"9898161"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10447158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10061871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SFRP4 Reduces Atherosclerosis Plaque Formation in ApoE Deficient Mice.","authors":"Hua Guan,&nbsp;Ting Liu,&nbsp;Miaomiao Liu,&nbsp;Xue Wang,&nbsp;Tao Shi,&nbsp;Fengwei Guo","doi":"10.1155/2023/8302289","DOIUrl":"https://doi.org/10.1155/2023/8302289","url":null,"abstract":"<p><p>Secreted frizzled related protein 4 (SFRP4), a member of the SFRPs family, contributes to a significant function in metabolic and cardiovascular diseases. However, there is not enough evidence to prove the antiatherosclerosis effect of SFRP4 in ApoE knock-out (KO) mice. ApoE KO mice were fed a western diet and injected adenovirus (Ad)-SFRP4 through the tail vein for 12 weeks. Contrasted with the control cohort, the area of atherosclerotic plaque in ApoE KO mice overexpressing SFRP4 was reduced significantly. Plasma high-density lipoprotein cholesterol was elevated in the Ad-SFRP4 group. RNA sequence analysis indicated that there were 96 differentially expressed genes enriched in 10 signaling pathways in the mRNA profile of aortic atherosclerosis lesions. The analysis data also revealed the expression of a number of genes linked to metabolism, organism system, and human disease. In summary, our data demonstrates that SFRP4 could play an important role in improving atherosclerotic plaque formation in the aorta.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2023 ","pages":"8302289"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10154090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10261310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valve-Sparing Aortic Root Replacement Technique: Valsalva Graft versus Two Straight Tubular Grafts.","authors":"Alexander Makkinejad,&nbsp;Bailey Brown,&nbsp;Rana-Armaghan Ahmad,&nbsp;Joanna Hua,&nbsp;Xiaoting Wu,&nbsp;Shinichi Fukuhara,&nbsp;Karen Kim,&nbsp;Himanshu Patel,&nbsp;G Michael Deeb,&nbsp;Bo Yang","doi":"10.1155/2023/4076881","DOIUrl":"https://doi.org/10.1155/2023/4076881","url":null,"abstract":"<p><strong>Background: </strong>There are many variations in valve-sparing aortic root replacement techniques. Our aim is to determine the impact of the graft on mid-term outcomes: Valsalva graft vs. two straight tubular grafts.</p><p><strong>Methods: </strong>From 2004 to 2020, 332 patients underwent valve-sparing aortic root replacement with either a Valsalva graft (Valsalva group: <i>n</i> = 270) or two straight tubular grafts (two-graft group: <i>n</i> = 62). Data were obtained through chart review and the National Death Index. Primary outcomes were mid-term survival and freedom from reoperation.</p><p><strong>Results: </strong>The preoperative characteristics of the groups were similar, but the two-graft group had more type A dissections (32% vs. 19%) and emergent operations (26% vs. 15%) and was younger (45 vs. 50 years). Intraoperatively, the groups were similar, but the two-graft group had longer cross-clamp (245 vs. 215 minutes) and cardiopulmonary bypass times (284 vs. 255 minutes). Postoperative complications including reoperation for bleeding, stroke, pacemaker implantation, and renal failure were slightly more frequent in the Valsalva group, but the differences were not significant. Operative mortality was similar between the Valsalva and two-graft groups (0.7% vs. 0%). Five-year survival in the two-graft group was 100% compared to 96% in the Valsalva group (<i>p</i>=0.56). Five-year freedom from reoperation in the two-graft group was 100% compared to 93% in the Valsalva group (<i>p</i>=0.29).</p><p><strong>Conclusions: </strong>The Valsalva and two-graft techniques both have excellent short- and mid-term outcomes. The two-graft technique might have slightly better survival and freedom from reoperation, but a larger sample size and longer follow-up are needed to determine if these advantages are significant.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2023 ","pages":"4076881"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10707873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Small Increase in Serum Creatinine within 48 h of Hospital Admission Is an Independent Predictor of In-Hospital Adverse Outcomes in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: Findings from the Improving Care for Cardiovascular Disease in the China Project.","authors":"Jiajia Zhu,&nbsp;Wenxian Liu,&nbsp;Jiang Li,&nbsp;Changsheng Ma,&nbsp;Dong Zhao","doi":"10.1155/2023/1374206","DOIUrl":"https://doi.org/10.1155/2023/1374206","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication of percutaneous coronary intervention (PCI) that has been associated with high morbidity and mortality in patients with STEMI. Acute tubular damage may be reflected by serum creatinine (Scr) values that do not meet the criteria for AKI.</p><p><strong>Methods: </strong>This analysis included 19,424 patients from the Improving Care for Cardiovascular Disease in China, Acute Coronary Syndrome Project (<i>n</i> = 5,221 (36.8%), patients with a small increase in Scr within 48 h of hospitalization; <i>n</i> = 14,203 patients with no increase in Scr). The primary outcome was the incidence of major adverse cardiovascular events (MACE). Secondary outcomes included the incidence of massive hemorrhage, in-hospital death, atrial fibrillation, heart failure, cardiogenic shock, cardiac arrest, and stroke. Logistic regression analysis was used to evaluate associations between a small increase in Scr within 48 h of hospitalization (>0.1 to <0.3 mg/dl) and MACE or massive hemorrhage during hospitalization.</p><p><strong>Results: </strong>Patients with a small increase in Scr within 48 h of hospitalization were significantly more likely to experience MACE (11.2% vs. 9.1%; <i>P</i> < 0.001) or massive hemorrhage (3.2% vs. 2.2%; <i>P</i> < 0.001) compared to patients with no increase in Scr, but there was no significant difference in in-hospital mortality (0.8% vs. 0.9%; <i>P</i>=0.301). Logistic regression analysis showed that a small increase in Scr within 48 h of hospital admission was a risk factor for MACE (OR, 1.168; 95% CI, 1.044-1.306; <i>P</i>=0.006) or massive hemorrhage (OR, 1.413; 95% CI, 1.164-1.715; <i>P</i> < 0.001). Other risk factors included age ˃65 years, history of heart failure, use of glycoprotein IIb/IIIa inhibitors, aspirin or ACEI/ARB, LVEF <40%, Killip class III-IV, and increased SBP and heart rate.</p><p><strong>Conclusion: </strong>A small increase in Scr during hospitalization in patients with STEMI undergoing primary PCI that does not meet the criteria for AKI is a risk factor for in-hospital adverse outcomes. This effect is maintained in patients with normal Scr at hospitalization. <i>Trial Registration</i>. Clinical trial registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02306616.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"2023 ","pages":"1374206"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9272007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}