Myocardial Infarction In Adults Research Articles

Association between the use of electronic cigarettes and myocardial infarction in U.S. adults

BackgroundCompared with conventional cigarettes, electronic cigarettes are less harmful in some studies. However, recent research may indicate the opposite. This study aimed to determine whether e-cigarette use is related to myocardial health in adults in the U.S.MethodsThis study used data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), a cross-sectional survey of adult US residents aged 18 years or older. We examined whether e-cigarette use was related to myocardial infarction byapplying a logistic regression model to calculate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsThe final analytical sample included 198,530 adults in the U.S. Logistic regression indicated that U.S. adults who reported being former and some days of e-cigarette use had 23% and 52% greater odds of ever having an MI, respectively, than did those who reported never using e-cigarettes (OR = 1.23, 95% CI 1.08–1.40, p = 0.001; OR = 1.52, 95% CI 1.10–2.09, p = 0.010).ConclusionsThe results suggest that former and someday users of e-cigarettes probably have increased odds of myocardial infarction in adults in the U.S. Further research is needed, including long-term follow-up studies on e-cigarettes, since it is still unknown whether they should be discouraged.

Association between PM10 exposure and risk of myocardial infarction in adults: A systematic review and meta-analysis.

Air pollution has several negative health effects. Particulate matter (PM) is a pollutant that is often linked to health adversities. PM2.5 (PM with an aerodynamic diameter of ≤2.5μm) exposure has been associated with negative cardiovascular (CV) outcomes. However, the impact of PM10 (PM with an aerodynamic diameter of ≤10μm) exposure is often overlooked due to its limited ability to pass the alveolar barrier. This study aims to assess the association between PM10 exposure and risk of myocardial infarction (MI) amongst adults (≥18 years of age) as this has been poorly studied. The study protocol was published on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023409796) on March 31, 2023. Literature searches were conducted on 4 databases (Ovid Medline, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Web of Science) on January 17, 2023, for studies looking at associations between PM and MI. English studies from all time periods were assessed. Studies selected for review were time-series, case-crossover, and cohort studies which investigated the risk of MI as an outcome upon PM10 exposure. The quality of evidence was assessed using Cochrane's Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Data for different risk outcomes (risk ratio (RR), odds ratio (OR), hazard ratio (HR)) and 3 lags was meta-analyzed using an inverse variance statistical analysis using a random effects model. The pooled effect sizes and the 95% confidence intervals (CIs) were reported in forest plots. Among the 1,099 studies identified, 41 were included for review and 23 were deemed eligible for meta-analysis. Our analysis revealed that there is an increased risk (OR = 1.01; 95% CI:1.00-1.02) of MI with a 10 μg/m3 increase in PM10 after a lag 0 and lag 1 delay. Our findings indicate that PM10 exposure is associated with an increased risk of MI. This can aid in informing environmental policy-making, personal-level preventative measures, and global public health action.

The Difference of Chest Pain in Adult and Elderly Patients with Acute Myocardial Infarction

Chest pain in an acute attack of myocardial infarction cannot be underestimated because this pain will have a harmful impact on the patient. Pain is influenced by personality, life stress, social economic factor, cognitive, and psychology factor. There is no study comparing chest pain between adult and elderly patients with coronary artery disease. Thus, this study to compare chest pain in patients with acute myocardial infarction in adults and the elderly. This research is a quantitative analytic study with a documentation study. With the purposive sampling technique, the number of samples in this study was 68 respondents. The statistical analysis employed the Mann Withney test. Out of total participant ( n=68), 72,1 % were elderly, 60,3 % were male and 79,4 % were STEMI. The results were obtained from the pain scale in adults with a mean value of 54.11 and a mean value at the elderly age 26.90 with a value of p (0.000). There is a significant difference between myocardial infarction pain in adults and acute myocardial infarction pain in the elderly. Adult more high intensity of pain than elderly patients. This study recommended that health workers so provide serious treatment for chest pain patients in elderly althaought the pain is not serious.

Visceral adiposity is associated with metabolic profiles predictive of type 2 diabetes and myocardial infarction

BackgroundVisceral fat (VF) increases risk for cardiometabolic disease (CMD), the leading cause of morbidity and mortality. Variations in the circulating metabolome predict the risk for CMD but whether or not this is related to VF is unknown. Further, CMD is now also present in adolescents, and the relationships between VF, circulating metabolome, and CMD may vary between adolescents and adults.MethodsWith an aim to add understanding to the metabolic variations in visceral obesity, we tested associations between VF, measured directly with magnetic resonance imaging, and 228 fasting serum metabolomic measures, quantified with nuclear magnetic resonance spectroscopy, in 507 adults (36–65 years) and 938 adolescents (12–18 years). We further utilized data from published studies to estimate similarities between VF and CMD-associated metabolic profiles.ResultsHere we show that VF, independently of body mass index (BMI) or subcutaneous fat, is associated with triglyceride-rich lipoproteins, fatty acids, and inflammation in both adults and adolescents, whereas the associations with amino acids, glucose, and intermediary metabolites are significant in adults only. BMI-adjusted metabolomic profile of VF resembles those predicting type 2 diabetes in adults (R2 = 0.88) and adolescents (R2 = 0.70), and myocardial infarction in adults (R2 = 0.59) and adolescents (R2 = 0.40); this is not the case for ischemic stroke (adults: R2 = 0.05, adolescents: R2 = 0.08).ConclusionsVisceral adiposity is associated with metabolomic profiles predictive of type 2 diabetes and myocardial infarction even in normal-weight individuals and already in adolescence. Targeting factors contributing to the emergence and maintenance of these profiles might ameliorate their cumulative effects on cardiometabolic health.

Evaluating the use of biomarkers for the diagnosis of myocardial injury in neonates

Myocardial infarction is defined as the obstruction of blood flow to the heart, resulting in oxygen deprivation. While myocardial infarction in adults is common and has sufficient diagnostic strategies, there remain gaps in the diagnostic strategies for myocardial infarction in neonates. Presently, biomarkers such as creatine-kinase MB, brain natriuretic peptide, myoglobin, and troponin are believed to be potential diagnostic tools for neonatal myocardial infarction. This literature review explores the efficacy of biomarkers for early diagnosis of neonatal myocardial infarction. The review concludes that creatine-kinase MB, brain natriuretic peptide, and myoglobin do not serve as accurate biomarkers for myocardial infarction in neonates. However, cardiac troponins, in particular cardiac troponin I, have high sensitivity and specificity for diagnosing myocardial injury. Cardiac troponins experience rapid elevation upon myocardial injury, and they remain unaffected by gestational age and birth weight. In addition, they do not cross the placenta and are therefore intrinsic to the neonate. Future research should be conducted to verify the accuracy, sensitivity, and specificity of cardiac troponins as myocardial infarction biomarkers.

ПРИЧИНЫ ПОВЫШЕНИЯ КАРДИАЛЬНЫХ ТРОПОНИНОВ У ДЕТЕЙ С СЕРДЕЧНО-СОСУДИСТОЙ ПАТОЛОГИЕЙ И ИХ ЗНАЧИМОСТЬ В КЛИНИЧЕСКОЙ ПРАКТИКЕ

Troponin I has been successfully used in the diagnosis of acute myocardial infarction in adults. According to recent studies the field of cardiac troponins was widely developed. Troponin I elevated in patients with heart failure, tachyarrhythmias, myocarditis, pulmonary hypertension, intoxications of cardiotoxic drugs, sepsis and other similar conditions. Most literature reviews represent information of using cardiac troponins only among adults. Pediatric publications contain much less information. There are no reference values and practical recommendations for troponin I in children. The aim of this article is to cover all available data of use and interpretation of troponin I in children with different cardiac pathology.

Factors Associated with Unawareness of Early Symptoms of Stroke and Myocardial Infarction in Adults with Hypertension and Diabetes: Focused on Management related to Disease

Factors Associated with Unawareness of Early Symptoms of Stroke and Myocardial Infarction in Adults with Hypertension and Diabetes: Focused on Management related to Disease

Abstract 15876: Tie1 is Essential for Cardiac Repair and Myocardial Regeneration

Introduction: Cardiac lymphatics are essential in resolving interstitial fluid and inflammatory infiltrate after a myocardial infarction in adults. Little is known about the role of the lymphatic system during neonatal cardiac regeneration following injury in the perinatal animal with an immature lymphatic system. Hypothesis: Our hypothesis is that TIE1, an endothelial specific receptor tyrosine kinase essential for lymphatic development in mice, is required for myocardial repair following infarction (MI) in both neonatal and adult mice. Methods: Using an inducible and lymphatic specific deletion model, Prox1Cre-ER T2 ;Tie1 fl/fl , both mutant and non-mutant control mice undergo myocardial MI with left anterior descending coronary ligation. Adult surgery is performed at 6-8 weeks of age. Conditional Tie1 deletion is induced by ingestion of tamoxifen enriched chow 48 hours prior to adult ligation and continued until dissection is performed; cardiac function is assessed throughout this time by echocardiogram. Neonatal surgery is performed at postnatal day 2 (P2) and conditional Tie1 deletion induced with intraperitoneal tamoxifen with functional assessment by echocardiogram at P4 and P21. Results: Adult control animals had a robust lymphangiogenic response within the scar infarct border zone at 6 weeks post-MI that was not seen in mutants at 6 weeks. Furthermore, Tie1 deletion following led to a an increase in maximal injury, severe depression of cardiac function, and a blunted myocardial repair response, noted by histological analysis of the scar area. Similarly, Tie1deletion in the neonatal period resulted in markedly attenuated regenerative response with persistent scar function at P21. Conclusions: Lymphatic expression of Tie1 in the adult is required for myocardial repair following injury. In addition, lymphatic expression of Tie1 is required for optimal myocardial regeneration in the neonate even though the cardiac lymphatic system is immature in the postnatal period. Further delineation of the mechanisms involved in Tie1 mediated repair and regeneration may provide novel opportunities for therapeutic intervention following cardiac injury in both neonates and adults.

An Aurora Kinase B-Based Mouse System to Efficiently Identify and Analyze Proliferating Cardiomyocytes.

To identify and analyze the live proliferating cardiomyocytes is crucial for deciphering the mechanisms controlling endogenous cardiac regeneration. Traditional methods confuse cell division with multinucleation in postnatal cardiomyocytes. Recent efforts have achieved significant progress on discerning cytokinesis from only nuclear division. However, those methods were either designed to label post-cytokinesis progeny or challenging to sort the live proliferating cardiomyocytes. In this study, we highlighted an Aurora kinase B reporter–based mouse system with a tdTomato fluorescence labeling. It could efficiently identify proliferating cardiomyocytes in neonates. The analysis of sorting tdTomato+ cardiomyocytes with different ploidy indicated that mononucleated cardiomyocytes might not possess significantly higher proliferating potential than other cardiomyocytes when most cardiomyocytes have become post-mitotic. Moreover, tdTomato+ cardiomyocytes were significantly increased and enriched at injury border zone after apex resection in neonates, while there were no increased tdTomato+ cardiomyocytes after myocardial infarction in adults.

Myocardial Protection with Beta Blocker Treatment in Infants with Heart Failure Due to Congenital Heart Defects and Duchenne Muscular Dystrophy

Our first intention to treat infants’ heart failure with beta blockers was to improve the clinical condition as shown in our prospective randomized trial. We only use non-selective beta blockers in these infants, carvedilol in those with left ventricular dysfunction and propranolol in those with congenital heart disease without ventricular dysfunction. Despite a significant improvement of Ross’s heart failure score, we could not convince most colleagues within the last 25 years if the concept of neurohumoral activation in heart failure is not well-established pediatric cardiology. Recently, Honghai Liu et al. published that cardiomyocyte cytokinesis failure was increased in congenital heart disease. Inactivation of the beta adreno receptors genes and administration of the beta-blocker propranolol increased cardiomyocyte division in neonatal mice, which increased the number of cardiomyocytes (endowment) and conferred benefit after myocardial infarction in adults. We currently realize that propranolol in infants with congenital heart disease not only decrease highly elevated NT-Pro-BNP values but also decrease cardiac troponin T values that may indicate myocardial injury due to neurohumoral activation. We reproduce this observation, primarily seen in infants with congenital heart disease, in an infant with Duchenne muscular dystrophy. These observations were in good accordance with current data from H. Liu et al., who showed that treatment with non-selective beta blockers early after birth might rescue cytokinesis defects and prevent heart dysfunction in adulthood in a mouse model.

Corticosteroid Use and Incident Myocardial Infarction in Adults Hospitalized for Community-acquired Pneumonia.

Adults hospitalized for community-acquired pneumonia (CAP) have an increased risk of myocardial infarction. Corticosteroid treatment lowers CAP morbidity and mortality, but it is not known whether it influences in-hospital myocardial infarction. The aim of the present study was to investigate the potential interplay between corticosteroid treatment and in-hospital myocardial infarction in adults with CAP. We retrospectively analyzed adults with CAP referred to the University Hospital Policlinico Umberto I (Rome, Italy), consecutively recruited, and prospectively followed until discharge. The primary outcome was the occurrence of myocardial infarction during hospitalization. We used propensity score-adjusted Cox models to examine the association between corticosteroid use and myocardial infarction. Seven hundred fifty-eight patients (493 males, 265 females; mean ± standard deviation age, 71.7 ± 14.4 yr) were included in the study. Of these, 241 (32%) were treated with systemic corticosteroids (methylprednisolone, betamethasone, or prednisone). During follow-up, 62 (8.2%) had a myocardial infarction during their hospitalization (incidence, 0.72 per 100 person-days; 95% confidence interval [CI], 0.55 to 0.92). Those treated with corticosteroids had a lower incidence of myocardial infarction (0.42 per 100 person-days) than those not treated with corticosteroids (0.89 per 100 person-days; absolute rate difference, -0.48 per 100 person-days; 95% CI, -0.85 to -0.10). In a propensity score-adjusted Cox model, corticosteroid use was associated with a lower incidence of myocardial infarction (hazard ratio, 0.46; 95% CI, 0.24 to 0.88; P = 0.02). We found that in-hospital corticosteroid treatment was associated with a lower incidence of myocardial infarction in adults hospitalized with CAP.

Abstract 17023: Early Incidence of First Myocardial Infarction in Adult Attention Deficit Hyperactivity Disorder Patients in the United States

Background: Behavioral patterns and pharmaceutical interventions in patients with attention deficit hyperactivity disorder(ADHD) might increase the risk of cardiovascular disease. Studies evaluating the differences in risk profiles and outcomes during first myocardial infarction in ADHD patients compared to the general population in the US are lacking. Methods: We performed a retrospective cohort analysis of the US National Inpatient Sample years 2005 - 2015 using appropriate ICD-9 codes to identify a weighted sample of hospitalizations for a first acute myocardial infarction (AMI) in adults. In this AMI cohort, patients with ADHD were identified. Differences in demographics, comorbidities, and outcomes were compared between patients with and without ADHD. Results: Of 4,285,185 first AMI cases, ADHD was present in 5379 (~1 in 1000). At the time of first AMI, patients with ADHD were 15 years younger (mean age 52 vs 67 years, p<.001) and were more likely to be men (72% vs 58%, p<.001) than those without. More patients with ADHD had private insurance and were in higher income categories; TABLE. Patients with ADHD had higher prevalence of substance abuse, smoking, obesity, dyslipidemia and depression whereas patients without ADHD had a higher prevalence of hypertension and diabetes mellitus. While the type of AMI was similar in both the groups, mechanical revascularization was more frequently performed in ADHD patients (69.4% vs 59.1%, p<.001). All-cause inhospital mortality during the first AMI was significantly lower in ADHD patients (1.3% vs 6.1%, p<.001). Conclusion: In the US, patients with ADHD had first AMI at a much younger age and had substantial differences in risk factor profile and outcomes compared to the general population. The influence of behavior patterns, underlying ADHD pathophysiology, and medical interventions in ADHD patients leading to the earlier AMI onset should be further explored.

Correction to: Air quality and acute myocardial infarction in adults during the 2016 Hangzhou G20 summit.

Unfortunately, the original publication of this paper contains a mistake. The correct name of the 1st Author is Ming-Wei Wang.

Air quality and acute myocardial infarction in adults during the 2016 Hangzhou G20 summit.

To fulfill its commitment to a successful Hangzhou G20 summit (4 to 5 September 2016), the Chinese government implemented a series of measures to improve the air quality in Hangzhou. We report findings on air quality and acute myocardial infarction (AMI) hospital admissions in adults during the Hangzhou G20 summit. Three study periods were defined. The first period was pre-G20 (28 July to 27 August: limited restrictions on industrial emissions). The second period was G20 (28 August to 6 September) when there were further restrictions on industrial emissions and increased transportation restrictions. The third period was post-G20 (7 September to 6 October) when restrictions were relaxed again. The mean number of AMI admissions per day was, respectively, 8.2 during G20, 13.3 during pre-G20, and 15.1 during post-G20. We used time-series Poisson regression models to estimate the relative risk (RR) for AMI associated with pollution levels. Our results suggest that the air quality improvement can reduce the number of hospital admissions for AMI.

Does heart-type fatty acid-binding protein predict clinical outcomes after pediatric cardiac surgery?

Introduction:The early identification of vulnerable pediatric cardiac surgery patients can help clinicians provide them with timely support. Heart-type fatty acid-binding protein. (H-FABP) is an early biomarker of myocardial injury in acute myocardial infarction in adults. In this study, we evaluated the correlations between postoperative H-FABP, creatine kinase-myocardial band (CK-MB), troponin-I, total bypass time, and clinical outcomes.Methods:In 32 pediatric patients that underwent ventricular septal defect. closure we measured H-FABP, troponin-I and CK-MB preoperatively and 1, 3, and 6 h after aortic declamping. Spearman's Rho correlations were calculated between laboratory and clinical parameters including inotropic support duration, aortic cross-clamp time, total bypass time, ventilation-weaning-time, and total Intensive Care Unit stay.Results:H-FABP, CK-MB, troponin-I, and total bypass time have a similarly weak to moderate correlation with clinical outcome measures.Conclusions:The predictive value of H-FABP for clinical outcome is not stronger than that of CK-MB, Troponin-I, or bypass times.

Comparative Efficacy and Safety of Everolimus-Eluting Bioresorbable Scaffold Versus Everolimus-Eluting Metallic Stents: A Systematic Review and Meta-analysis.

Theoretically, the everolimus-eluting bioresorbable vascular scaffold (BVS) could eliminate stent thrombosis and improve outcomes in patients having percutaneous coronary intervention. To estimate the incidence of stent thrombosis after BVS implantation and to compare the efficacy and safety of BVSs versus everolimus-eluting metallic stents (EESs) in adults having percutaneous coronary intervention. PubMed, EMBASE, Cochrane Central Register of Controlled Trials, conference proceedings, and relevant Web sites from inception through 20 January 2016. 6 randomized, controlled trials and 38 observational studies, each involving at least 40 patients with BVS implantation. Two reviewers independently extracted study data and evaluated study risk of bias. The pooled incidence of definite or probable stent thrombosis after BVS implantation was 1.5 events per 100 patient-years (PYs) (95% CI, 1.2 to 2.0 events per 100 PYs) (126 events during 8508 PYs). Six randomized trials that directly compared BVSs with EESs showed a non-statistically significant increased risk for stent thrombosis (odds ratio [OR], 2.05 [CI, 0.95 to 4.43]; P= 0.067) and myocardial infarction (OR, 1.38 [CI, 0.98 to 1.95]; P= 0.064) with BVSs. The 6 observational studies that compared BVSs with EESs showed increased risk for stent thrombosis (OR, 2.32 [CI, 1.06 to 5.07]; P= 0.035) and myocardial infarction (OR, 2.09 [CI, 1.23 to 3.55]; P= 0.007) with BVSs. The relative rates of all-cause and cardiac death, revascularization, and target lesion failure were similar for BVSs and EESs. Scarce comparative data, no published data from large trials with long-term follow-up, and limited quality and incomplete reporting of observational studies. Compared with EESs, BVSs do not eliminate and might increase risks for stent thrombosis and myocardial infarction in adults having percutaneous coronary intervention. Results of large trials with long-term follow-up are critically needed to establish the safety or at least the noninferiority of BVSs compared with EESs. None.

Acute Myocardial Infarction in Adult Congenital Patients with Bodily Isomerism.

Children born with congenital malformations of the heart are increasingly surviving into adulthood. This population of patients possesses lesion-specific complication risks while still being at risk for common illnesses. Bodily isomerism or heterotaxy, is a unique clinical entity associated with congenital malformations of the heart which further increases the risk for future cardiovascular complications. We aimed to investigate the frequency of myocardial infarction in adults with bodily isomerism. We utilized the 2012 iteration of the Nationwide Inpatient Sample to identify adult inpatient admissions associated with acute myocardial infarction in patients with isomerism. Data regarding demographics, comorbidities and various procedures were collected and compared between those with and without isomerism. A total of 6,907,109 admissions were analyzed with a total of 172,394 admissions being associated with an initial encounter for acute myocardial infarction. The frequency of myocardial infarction did not differ between those with and without isomerism and was roughly 2% in both groups. Similarly, the number of procedures and in-hospital mortality did not differ between the two groups. The frequency and short-term prognosis of acute myocardial infarction is similar in patients with and without isomerism.

Missed Kawasaki disease in childhood presenting as myocardial infarction in adults

Kawasaki disease (KD) is an acute, self-limited vasculitis that occurs in young children and was first described by Japanese pediatrician Tomisaku Kawasaki in 1967. Although originally thought to be a rare condition, KD has become the most common cause of acquired heart disease in the pediatric population in developed countries. The majority of patients with KD appear to have a benign prognosis, but a subset of patients with coronary artery aneurysms are at risk for ischemic events and require lifelong treatment. In the 4 decades since the initial recognition of KD, the number of patients reaching adulthood has continued to grow. Adult cardiologists will be increasingly involved in the management of these patients. Currently, there are no established guidelines for the evaluation and treatment of adult patients who have had KD. We report 4 most probable cases of KD missed in childhood and presented as acute coronary syndrome in adulthood.

Propranolol to treat infantile hemangioma (IH) in patients with congenital heart disease

To the Editor: Although propranolol has long been used for treating hypertension, angina pectoris, tachyarrhythmia, and myocardial infarction in adults, clinical trials to determine its safety in pediatric patients with infantile hemangioma (IH) are ongoing.1 Reports of propranolol use in patients with IH and congenital heart disease are scarce.

Role of birthplace in chronic disease in adults and very old individuals: national cohorts in the UK and USA, 2009–2010

ObjectivesTo understand the role of birthplace in chronic disease in adults and very old individuals. Study designTwo national and population-based studies (UK Longitudinal Household Survey and US National Health and Nutrition Examination Surveys) in 2009–2010 were included. MethodInformation on demographics, lifestyle factors and self-reported chronic diseases was obtained by household interview. Analyses included Chi-squared test, t-test and logistic regression modelling. ResultsIn the UK, there were more cases of heart failure and myocardial infarction in adults (aged 20–79 years) born in Scotland, and more cases of coronary heart disease in adults born in Northern Ireland. There were fewer cases of asthma, depression and hypothyroidism in adults born in Northern Ireland and not born in the UK, and fewer cases of cancer, chronic bronchitis and epilepsy in adults not born in the UK. In USA, there were fewer cases of asthma, cancer, chronic bronchitis, heart failure and heart attack, but more cases of liver disease in adults born in Mexico. Similarly, there were fewer cases of asthma, cancer and chronic bronchitis in adults born in other Spanish or non-Spanish countries, although there were more cases of liver disease in other Spanish-born adults and more cases of diabetes in other non-Spanish-born adults. In very old (≥80 years) individuals, there were more cases of chronic bronchitis in those born in Wales, more cases of myocardial infarction in those born in Northern Ireland, and more cases of diabetes and liver disease in those not born in the UK. Overall, diabetes was more common in foreign-born adults, and respiratory illness and cancer were more common in native-born adults. ConclusionsIt is suggested that future health policy and public health programmes should consider birthplace.