bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperglycemia and stress response in acute coronary syndromes
Authors: Swieszkowski S , Costa D , Aladio M , Matsudo M , Perez De La Hoz A , Lopez GL , Brignoli A , Perez De La Hoz R 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): University of Buenos Aires

Background
Cortisol is a stress marker in patients with acute coronary syndrome (ACS) and it has a permissive effect on the actions of hormones that increase glucose production. Its association with blood glucose levels in diabetic and non-diabetic patients could help to understand the relationship between stress, hyperglycaemia and mortality.

Methods
Prospective and observational single-centre study. All patients admitted with a diagnosis of ACS to the coronary care unit of a University Hospital were included. The age, sex and clinical characteristics were recorded, along with the clinical outcomes. On admission, blood samples were obtained to measure serum glucose (SG) and cortisol (SC).

Results
Over a total of 149 patients, 35.37% had a diagnosis of ST-segment elevation ACS. Median age was 69 (60.1 – 79) years, 61.1% were male, 59.5% were hypertense, 18.2% dyslipidemic, 23% smokers, and 28.4% diabetics. Total mortality during hospitalization was 6.8%, and cardiovascular mortality was 6.1%.
We observed a significantly higher SC and SG on admission in patients who died (table 1), with a mild and positive correlation between them (Spearman’s rho = 0.24, p = 0.005). Diabetic patients had a higher SG on admission [191.1 mg/dl (157.5 – 250,8) vs. 116.0 mg/dl (99.0 – 141.0), &lt; 0.001]. Diabetes was not associated with mortality, although correlation between glucose and cortisol remained constant in diabetics and non-diabetics (figure 1).

Conclusion
Hypercortisolemia and hyperglycaemia were associated with an increased in-hospital mortality. Although hyperglycemia confers a worse prognosis, we found that its correlation with cortisol was constant in diabetics and non-diabetics. This suggests that hyperglycaemia could be a surrogate stress marker, not related to diabetes as a risk factor in an acute setting. Serum glucose and cortisol on admission LaboratorySurvivorsNon-survivorsp-valueGlucose (mg/dL)128 (101 - 163)156 (134.5 - 197.2)0.04Cortisol (ug/dL)13.7 (7,98 - 23.65)43.7 (34.6 - 50.0)0.0004Abstract Figure. Serum cortisol and glucose on admission.
Influence of plasma ST2 level on myocardial remodeling in NSTEMI
Authors: Maslovskyi VI , Mezhiievska IA 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Objective
to establish a relationship between types of myocardial remodeling and plasma ST2 levels in NSTEMI.
Methods. 90 patients with NSTEMI were examined. Features of structural and functional condition of the myocardium were determined by echocardiography in M-, B, and D-modes.
All of research corresponding to the principles of the Declaration of Helsinki of the World Medical Association.
Results. It is established, that relatively low level (RL) corresponded to 24, the relatively moderate level (RM) to 44, and the relatively high (RH) level of ST2 to 24 individuals, respectively. For patients in the main group, these levels were &lt; 26 and &gt; 56 ng / ml, respectively. Instead, the relatively moderate (or intermediate) ST2 level (RM) for these patients was 26-56 ng / ml.
It was determined that in patients with explosives in comparison with RH levels of ST2 in blood plasma there is a significant increase in the value of LA (42 mm vs. 38 mm, p-0.03), iLA (20.3 mm / m2 vs. 18.3 mm / m2, p-0.04), ESS (36 mm vs. 32 mm, p-0.008), EDS (52 mm vs. 49 mm, p-0.04), Ve / Va ratio (0.79 vs. 0.74, p-0.03), iLC (2.72 vs. 2.06, p = 0.03), iMMLV (121 g / m2 vs. 108 g / m2, p = 0.04), a decrease in the ratio of RV to EDS (0.49 vs. 0.54, p = 0.01) and the value of EF (56% vs. 61%, p = 0.03) (Tab. 1). The ratio of LA to RA was 1.13 against 1.06, p= 0.04. In addition, in patients with RH level compared with patients with RM level, there was a significant increase in the value of ESS (36 mm vs. 34 mm, p = 0.05). The ratio of Ve / Va was 0.79 vs. 0.66, p =0.01, iLC -2.72 vs. 2.43, p-0.0006.
Conclusion. Elevated ST2 levels greater than 56 ng / ml in patients with NSTEMI were found to be associated with more severe structural left ventricular remodeling, left atrial overload, and decreased left ventricular contractility. The latter is manifested by a decrease in the value of PV and an increase in the value of Ve / Va, which changes in the direction of the formation of a restrictive type of diastolic transmitral blood flow. In turn, the ratio of RV to EDS shows the advantage of LV dilatation over RV. Tab. 1Echo indicatorsRL level ST2RM level ST2RH level ST2PLA, mm38 (35; 39)39 (37; 41)42 (37; 42)Р1-3 = 0,03EDS, mm49 (46; 52)50 (48; 53)52 (48; 54)Р1-3 = 0,04EF, %61 (59; 64)59 (53; 62)56 (58; 60)Р1-3 = 0,03Ve/Va0,64 (0,56; 0,78)0,66 (0,58; 0,74)0,79 (0,60; 1,20)Р1-3 = 0,03 Р2-3 = 0,01іММLV, g/m2108 (91; 117)115 (100; 127)121 (106; 130)Р1-3 = 0,04
Dynamics of kidney M1 and M2 macrophages in patients with myocardial infarction
Authors: Kercheva M , Kercheva M , Rebenkova M , Kim B , Ilianova I , Kolmakov A , Ryabtseva A , Gombozhapova A , Rogovskaya Y , Kzhyshkowska J , Ryabov V 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): The reported study was funded by RFBR. Project number 19-315-60005.

Introduction
Heart-kidney axis is an active participant of the formation and progression of chronic heart and renal failure in patients with myocardial infarction (MI). Innate immunity play a great role in this collaboration between the heart and kidney according to the experimental data. However, there is not enough data about clinical studies.

Purpose
to assess the dynamics of kidney CD68+, CD80+, CD206+, CD163+ and stabilin-1+ macrophages in patients with fatal MI.
Methods and results: 30 patients with fatal MI type 1 were included. STEMI was in 87% (n = 26), in 53% (n = 16) it was recurrent MI. Chronic kidney disease was diagnosed in 33% (n = 10). They were divided according to the timeline of MI histopathology into 2 groups: early phase – inflammatory and reparative periods (to the 3d day after MI), late phase - regenerative and late periods (from the 3d to the 28 day after MI). Macrophages infiltration was assessed by immunohistochemistry. CD68+ was used, as a biomarker for M1 and M2 macrophages; CD80+, as a biomarker for M1 macrophages; stabilin-1+ and CD163+, CD206+, as only for M2 macrophages. The numbers of kidney CD68+ macrophages did not change significantly during the 28 days after MI: 42.8 ± 8 (early phase), 36.4 ± 13 (late phase). The numbers of kidney stabilin-1+ cells did not change also 2.1 ± 1 (early phase), 2.4 ± 1 (late phase), as CD163+ 59.51 ± 6 (early phase), 65.9 ± 25 (late phase). However, the numbers of CD206+ cells (M2 macrophages) increased from the early to the late phase: from 2 ± 1 to 8.5 ± 1 (p = 0.0001). The numbers of CD80+ cells (M1 macrophages) decreased from the early to the late phase from 4.2 ± 1 to 2 ± 1 (p = 0.02).

Conclusions
The number of kidney CD68+, CD163+ and stabilin-1+ macrophages did not show significantly dynamics during the first 28 days after myocardial infarction. We have noted the increase of CD206+ macrophage infiltration in kidney from the early phase after myocardial infarction to the late phase. Dynamics of CD80+ cells was the opposite; they decreased to the late phase after myocardial infarction.
Acute coronary syndrome in COVID-19 patients. Clinical features, severity and outcomes. Results from Spanish multicenter registry Car-COVID19
Authors: Abellas Sequeiros M , Sanmartin Fernandez M , Cosin Sales J , Corbi Pascual M , Escudier Villa JM , Garcia Del Egido A , Becerra Munoz VM , Martinez Dolz L , Gonzalez Juanatey C , Raposeiras Roubin S , Barge Caballero E , Jorge Perez P , Baron Esquivas G , Anguita Sanchez M , Zamorano JL 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Fundación del Corazón

Introduction
COVID19 has spread uncontrollably all over the world through this 2020 year. As a new entity, we did not know the potential cardiovascular manifestations of this infectious disease. This national registry was created to describe the cardiac affection and its severity.

Methods and results
A multicenter registry was conducted, including 28 centers in Spain. Patients with COVID19 diagnosis presenting an acute cardiovascular event between March 1st and May 30th were included. Eighty-two patients were included. Of them, 49 (76,6%) presented with acute coronary syndrome; the rest were diagnosed of acute myocarditis or stress cardiomyopathy. The majority of cases were STEMI (n = 31), while the remaining 35,4% presented as NSTEMI. 29 patients (61,7%) underwent emergent percutaneous coronary intervention (PCI) (Figure 1). Anterior (n = 18) and inferior (n = 16) were the most frequent locations. Coronary angiogram showed total occlusion in 20 patients (55,6%); while 7 patients presented with non-obstructive coronary arteries. PCI was done in 31 patients.
Eight patients (17,8%) developed Killip III-IV myocardial infarction. A total of 10 patients required endotracheal intubation and vasoactive agent were needed in 11 patients; none required IABP or ECMO. In-hospital mortality rate was 26,2%.

Conclusions
Patients with COVID19 may present with acute coronary syndromes. This entity has a poor prognosis, with noteworthy mortality. Table 1. Baseline characteristics.n (%)Age69,0[63,0-76,5]Sex (female)9 (19,1%)Hypertension28 (57,1%)Dyslipidemia25 (51,0%)Diabetes mellitus11 (22,4%)Chronic coronary disease10 (20,4%)Previous PCI10 (20,4%)Previous CABG0Previous AAS15 (30,6%)Smoking10 (20,4%)PCI percutaneous coronary intervention; CABG: coronary artery bypass graft; AAS: aspirin.Abstract Figure 1.
Trends in major bleeding events in patients with acute coronary syndrome
Authors: Cordero A , Escribano D , Bertomeu-Gonzalez V , Quintanilla MA , Moreno-Arribas J , Perez-Berbel P , Zuazola P 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
bleeding events incidence has gained a crucial role in acute coronary patients (ACS) due to its independent effect prognostic value.

Methods
we assessed trends of in-hospital and first-year-after-discharge major bleeding (MB) events in all ACS admitted in a single center between January 2009 and June 2019. MB was defined as those fitting definitions 3 or 5 of the BARC consortium. Patients were categorized as high-bleeding risk (HBR) according to the 2019 Academic Research Consortium HBR consensus if they met at least one major or two minor criteria. Inclusion period was divided in 3 groups: 2009-2012 (n = 884;29.5%), 2013-2015 (n = 1,046; 34.9%); 2016-2019 (n= 1,065; 35.6%). In-hospital MB was assessed by logistic binary regression and results are presented as odds ratio (OR); post-discharge MB were assessed by competing events regression models, taking all-cause mortality as a competing event, and results are presented as sub-hazard ratio (sHR).

Results
we included 2995 patients, mean age was 68.5 (13.0), 26.2% females, 32.9% had diabetes and 42.4% STEMI. A total of 1,163 (38.8%) were categorized as HBR patients. A non-significant trend to higher incidence of in-hospital MB was noted through the 3 time periods: 1.36%; 1.43%; 2.63 (p = 0.056) and it was mainly driven by the significant increase only in HBR patients: 2.54%; 4.60%; 7.67% (p = 0.002). Multivariate analysis identified age (OR: 1.06 95% CI 1.03-1.08, p &lt; 0.001) and the time period 2016-2019 (OR: 1.93 95% CI 1.13-3.31; p = 0.017) as main variables associated to higher in-hospital MB.
In contrast, postdischarge MB decreased over time periods: 6.0%; 4.59%; 2.07% (p &lt; 0.01). The decreasing trend was mainly driven by the reduction of MB in HBR patients (figure). The competing risk regression analysis, adjusted by age, gender, previous cardiovascular disease, revascularization and medical treatments, identified an independent association between lower post-discharge MB risk and the time period 2016-2019 (sHR: 0.56 95% CI 0.35-0.90; p = 0.017). Conversely, diabetes (sHR: 1.52 95% CI 1.01-2.28) and previous heart failure (sHR: 2.42 95% CI 1.14-5.14) were associated to higher risk of MB.

Conclusions
This continuous 10-year registry highlights the opposite trend of in-hospital vs. postdischarge MB that was mainly driven by reductions in HBR patients with ACS. The advances in post-discharge MB reductions should be take under consideration to prevent and avoid in-hospital MB. Abstract Figure.
The impact of lockdown enforcement during the SARSCoV-2 pandemic on the timing of presentation and early outcomes of patients with ST-elevation myocardial infarction
Authors: Kobo O , Efraim R , Saada M , Kofman N , Abu Dogosh A , Abramowitz Y , Aronson D , Minha S , Roguin A , Meisel SR 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
We aimed to explore whether the lockdown enforced during the SARSCoV-2 pandemic in Israel impacted the characteristics of presentation, reperfusion times, and early outcomes of ST-elevation myocardial infarction (STEMI) patients.

Methods
A multicenter prospective cohort comprising all STEMI patients treated by primary percutaneous coronary intervention admitted to four high-volume cardiac centers in Israel during lockdown (20/3/2020 - 30/4/2020). STEMI patients treated during the same period in 2019 served as controls.

Results
The study comprised 243 patients, 107 during the lockdown period of 2020 and 136 during the same period in 2019, with no difference in demographics and clinical characteristics. Patients admitted in 2020 had higher admission and peak troponin levels, had a 2.4 fold greater likelihood of Door-to-balloon times&gt; 90 min (95%CI: 1.2-4.9, p = 0.01) and 3.3 fold greater likelihood of pain-to-balloon times&gt; 12 hours (OR 3.3, 95%CI: 1.3-8.1, p &lt; 0.01). They experienced higher rates hemodynamic instability (25.2% vs 14.7%, p = 0.04), longer hospital stay (median, IQR [4 ,3-6 Vs 5, 4-6 ,p = 0.03]), and fewer early (&lt;72 hours) discharge (12.4% Vs 32.4%, p &lt; 0.001).

Conclusions
The lockdown imposed during the SARSCoV-2 pandemic was associated with a significant lag in the time to reperfusion of STEMI patients. Lockdown period 2020OR (95% CI)P valueD2B &gt; 90 min2.4 (1.2-4.9)0.01P2B &gt; 12 hours3.3 (1.3-8.1)&lt;0.01D2B: Door-to-Balloon, P2B: Pain-to-BalloonReference group: 2019 admissions; Adjusted to age, gender, ischemic heart disease, hypertension, Smoker, diabetes mellitus, and dyslipidemia. D2B: Door-to-Balloon, P2B: Pain-to-Balloon
Prevalence and main causes of myocardial infarction type 2 in the structure of in-hospital mortality
Authors: Leonova I , Oblavatsky D , Boldueva S 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Purpose
the assessment of the proportion of myocardial infarction (MI) type 2 in the structure of mortality in a multidisciplinary hospital
Material and methods. A retrospective study was made of 1,574 autopsy protocols carried out in a multidisciplinary hospital in the period from 01.01.10 to 31.12.16, of which a group with postmortem type II MI was identified. The control group was composed of persons who died from proven atherothrombotic type 1 MI
Results. In 360 cases (22.87%), the cause of death was MI. Of these, 137 cases were due to type 2 MI. The ratio of men and women was the same. Type 2 MI more often developed in elderly (48.2%) and senile (34.3%) ages; the average age of patients with type 2 MI was 71.7 ± years (68.2 ± 3 years among men and 75.3 ± 4 years among women p &lt;0.05), which did not differ from the group with fatal type 1 MI. The main causes of death in type 2 MI were tachysystolic arrhythmias - 59.12% of cases, severe hypoxia of any etiology - 35.04%. The absence of significant stenoses of coronary artery (CA) is significantly more common in type 2 MI, and multivessel disease - in type 1 MI. In the group of patients with type 1 MI, 67.29% had multivessel lesions (Table 1).
When comparing mortality in different departments of a multidisciplinary hospital, it turned out that only 29.2% of patients with type 2 MI were initially hospitalized in the cardiology department; 45.3% of patients - therapeutic, 25.5% of patients – surgical.
Conclusion. Nearly one in four patients dies as a result of MI, with more than 1/3 of fatal MIs occurring in type 2 MI. The main reasons for the development of type 2 MI: tachysystolic arrhyhythmias - 59.12%, hypoxia of various origins - 35.04%, sepsis - 2.2%. 25% of fatal type 2 MIs occurred in surgical patients. Table 1. CA in type 1 and 2 MISign1 type MI (n = 223)2 type MI (n = 137)рNo significant stenosis2,24%32,85%0,001Single CA significant stenosis8.07%12,41%0,1932-CA significant stenosis23,3%23,36%0,272Multivessel stenosis66,4%31,38%0,005Occlusion of at least one СА48,9%4,38%0,001
Searching for ST-segment elevation myocardial infarction markers by absorption spectra analysis of exhaled air samples
Authors: Syrkina A , Ryabov VV , Borisov AV , Zakharova OA , Kistenev YV 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Myocardial infarction is one of the main causes of mortality and disability. The standard diagnosis of myocardial infarction is associated with cardiospecific enzymes blood sampling. At the same time, it is of interest to search for new non-invasive myocardial necrosis markers, and there are few data in the periodicals on exhaled metabolites in myocardial infarction patients.
Purpose. Detecting specific molecules or their combination for ST-segment elevation myocardial infarction patients in exhaled air by analyzing the spectroscopic characteristics of exhaled air samples.
Methods. The target group included 17 patients. The control group included 18 healthy volunteers. Inclusion criteria for the target group: primary STEMI; admission within 12 hours from the onset of STEMI; age 18 and older. All patients underwent standard diagnostics of AMI, including determination of CPK, CPK-MB, troponin. Exclusion criteria: acute illness, or exacerbation of chronic, major surgery 1 month before myocardial infarction; severe lung pathology; congestive heart failure III, IV NYHA class; impossibility of air sampling due to various reasons.
In parallel, on the 1st day of hospitalization, as early as possible, air samples were taken on fasting. To do this, the patient three times calmly, until the lungs are completely empty, exhales into the surrounding space, at the end of the third exhalation - into a one-off air intake, which then was closed hermetically.
The absorption spectra of samples of exhaled air were determined using the method of laser optical-acoustic spectroscopy and using a system for terahertz spectroscopy with time resolution. A comparative analysis of the spectra of samples of exhaled air for the 1st and 2nd ranges was carried out.
The obtained spectra of exhaled air samples were analyzed using the principal component analysis. Statistical data processing was carried out by the STATISTICA 10.0.
Results. Absorption spectra of exhaled air samples were obtained in two ranges - infrared (range 1, wavelength: 2.5-10 μm - using the method of laser optical-acoustic spectroscopy) and terahertz (range 2, frequency: 0.3-2 THz - s using a terahertz time-resolved spectroscopy system). A comparative spectra analysis of exhaled air samples for the 1st and 2nd ranges was carried out. It is shown that in the Principal Component space of the vector set of signs for the spectra of exhaled air samples in ranges 1 and 2, corresponding to healthy patients and patients with primary myocardial infarction, it is possible to perform a visual separation.
Conclusion. With the help of optical-acoustic and terahertz spectroscopy, a specific combination of substances in the exhaled air for patients with ST-segment elevation myocardial infarction was found.
Role of neutrophil-lymphocyte ratio in predicting mortality in acute coronary syndrome patients
Authors: Imani AL , Setianto BY , Taufiq N , Bagaswoto HP , Damarkusuma A 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Inflammation is the basic mechanism of acute coronary syndrome (ACS). Among the various inflammatory markers related to ACS is the neutrophil-lymphocyte ratio (NLR). Neutrophils act as a mediator of inflammatory response to acute damage of myocardium, while lymphocytes decrease because of apoptosis caused by inflammation. Therefore, high NLR suggests further risk of infarction of the myocardium.

Purpose
This study determines the cut-off value and the role of NLR at admission in predicting in-hospital mortality of ACS patients.

Methods
A retrospective cohort study was conducted using data of patients admitted with ACS from the SCIENCE registry between February 2019 and November 2020. The inclusion criterion was complete blood count measurement at presentation. NLR was calculated from the absolute neutrophil and lymphocyte count. The optimal cut-off value of NLR was determined using receiver operating characteristic (ROC) curve and Youden index (J) analysis. Patients was divided into two groups based on the NLR cut-off value. In-hospital mortality between the two groups was compared using Chi-square test with a risk estimate to obtain the relative risk.

Results
A total of 1147 ACS patients aged 60,70 ± 10,951 years old were included in the study. Area under the ROC curve was 0,607 (95% CI: 0,559-0,655; p &lt;0,001). The optimal cutoff value of NLR to predict mortality was 10,7566 (sensitivity: 39,8%, specificity: 79,5%, J: 0,193). In-hospital mortality occurred in 64 of 266 (24,1%) patients with NLR &gt;10,7566 and in 97 of 881 (11%) patients with NLR &lt;10,7566, with relative risk 2,185 (95% CI: 1,645-2,904; p &lt;0,001).

Conclusion
In ACS patients with NLR &gt;10,7566, there is an increased mortality risk 2,185 times higher compared to ACS patients with NLR &lt;10,7566. Therefore, NLR can be used to predict in-hospital mortality in ACS patients. Mortality incidence between NLR groupsNLR &gt;10.7566 (n= 266)NLR &lt;10.7566 (n= 881)P-valueRelative risk95% CIMortality64 (24.1%)97 (11%)&lt;0.0012.1851.645-2.904Non-mortality202 (75.9%)784 (89%)NLR neutrophil-lymphocyte ratio, CI: confidence interval, P-value considered significant if &lt;0.005Abstract Figure. ROC curve of NLR