Treatment Of Acute Myocardial Infarction Research Articles

Evaluation of an educational intervention into an emergency department to improve diagnosis and early treatment in STEMI

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Government of Catalonia (Spain) provided funding for this research, with a grant issued in 2019 within the framework of the Strategic Health Research and Innovation Plan (PERIS) 2016-2020 to Gemma Berga Congost Background Clinical guidelines recommend some quality indicators to measure the effectiveness of ST-elevation acute myocardial infarction (STEMI) treatment. Adherence to these indicators is complex in atypical presentations, due to delayed diagnosis. Ongoing training is a useful tool in improving STEMI diagnosis. Our aim was to evaluate the impact of a training intervention incorporating clinical simulation tools for emergency triage nurses and doctors on STEMI diagnosis. Methods a prospective observational study was carry out in a STEMI hub hospital. All emergency professionals gave their consent and were included into the training. A theoretical-practical training activity with clinical simulation was designed and implemented in June 2021. Pre and post knowledge were assessed using a questionnaire validates by a group of experts and a validated satisfaction survey was performed. Results 20 professionals were included, 16 nurses and 4 physicians. 95% viewed all the online content and participated into the face-to-face training. All fulfilled the questionnaire pre-training and 70% the post-training. A 50% increase in the knowledge, evaluated by questionnaire, was observed. 80% of the participants evaluated as satisfactory the intervention with an excellent rating was obtained. Conclusion There was a high degree of participation into the training. The knowledge of the participants increased by more than 50% and their satisfaction with the educational intervention was excellent. Future studies are required to assess the impact of training on STEMI response time, clinical outcomes and mortality.

Declining risk of heart failure hospitalization following first acute myocardial infarction in Scotland between 1991-2016.

Mortality from acute myocardial infarction (AMI) has declined, increasing the pool of survivors at risk of later development of heart failure (HF). However, coronary reperfusion limits infarct size and secondary prevention therapies have improved. In light of these competing influences, we examined long-term trends in the risk of HF hospitalization (HFH) following a first AMI occurring in Scotland over 25 years. All patients in Scotland discharged alive after a first AMI between 1991 and 2015 were followed until a first HFH or death until the end of 2016 (minimum follow-up 1 year, maximum 26 years). A total of 175 672 people with no prior history of HF were discharged alive after a first AMI during the period of study. A total of 21 445 (12.2%) patients had a first HFH during a median follow-up of 6.7 years. Incidence of HFH (per 1000 person-years) at 1 year following discharge from a first AMI decreased from 59.3 (95% confidence interval [CI] 54.2-64.7) in 1991 to 31.3 (95% CI 27.3-35.8) in 2015, with consistent trends seen for HF occurring within 5 and 10 years. Accounting for the competing risk of death, the adjusted risk of HFH at 1 year after discharge decreased by 53% (95% CI 45-60%), with similar decreases at 5 and 10 years. The incidence of HFH following AMI in Scotland has decreased since 1991. These trends suggest that better treatment of AMI and secondary prevention are having an impact on the risk of HF at a population level.

Formation and evolution of surgical methods for treatment of stable coronary heart disease and acute myocardial infarction (review of literature)

Currently, two methods of coronary revascularization are used in coronary surgery – percutaneous coronary interventions and coronary bypass grafting. Technical capabilities allow using them both for the treatment of chronic coronary heart disease and in surgery for acute myocardial infarction.The development of cardiosurgical and endovascular areas has gone through two main stages. The first was to develop and improve the methodology itself and the second was to create standards and recommendations governing the treatment of coronary heart disease based on experience and accumulated results. At the present stage, individual technical aspects are subject to even greater standardization, which relate to both the selection and preparation for surgical treatment and individual stages of revascularization.

Potential diagnostic biomarkers: 6 cuproptosis- and ferroptosis-related genes linking immune infiltration in acute myocardial infarction

The current diagnostic biomarkers of acute myocardial infarction (AMI), troponins, lack specificity and exist as false positives in other non-cardiac diseases. Previous studies revealed that cuproptosis, ferroptosis, and immune infiltration are all involved in the development of AMI. We hypothesize that combining the analysis of cuproptosis, ferroptosis, and immune infiltration in AMI will help identify more precise diagnostic biomarkers. The results showed that a total of 19 cuproptosis- and ferroptosis-related genes (CFRGs) were differentially expressed between the healthy and AMI groups. Functional enrichment analysis showed that the differential CFRGs were mostly enriched in biological processes related to oxidative stress and the inflammatory response. The immune infiltration status analyzed by ssGSEA found elevated levels of macrophages, neutrophils, and CCR in AMI. Then, we screened 6 immune-related CFRGs (CXCL2, DDIT3, DUSP1, CDKN1A, TLR4, STAT3) to construct a nomogram for predicting AMI and validated it in the GSE109048 dataset. Moreover, we also identified 5 pivotal miRNAs and 10 candidate drugs that target the 6 feature genes. Finally, RT-qPCR analysis verified that all 6 feature genes were upregulated in both animals and patients. In conclusion, our study reveals the significance of immune-related CFRGs in AMI and provides new insights for AMI diagnosis and treatment.

The role of erythropoietin in the regulation of cardiac tolerance to impact of ischemia and reperfusion

Acute myocardial infarction (AMI) is one of the main causes of mortality among the able-bodied population in Russia and the population of economically developed countries. In recent years, deaths from AMI in the USA and Europe have not decreased. This is due to the lack of highly effective drugs for the treatment of AMI. One of the promising drugs to improve the survival of patients with AMI is erythropoietin. We searched for full-text publications in the PubMed database and on the website of the journal Nature. In studies performed on animals, it was shown that erythropoietin (5000 U/kg) is able to increase cardiac tolerance to ischemia and reperfusion due to activation of a number of kinases (PKC, ERK1/2, Akt, JAK2, PI3K) and due to GSK-3β kinase inactivation. Erythropoietin prevents post-infarction remodeling of the heart and enhances the process of myocardial neovascularization in rats and dogs. Erythropoietin in used doses (on the average 1000 U/kg) does not affect infarct size in patients with AMI and does not have an effect on post-infarction ventricular remodeling in humans. The reason for this discrepancy between experimental and clinical data remains unclear. It is possible that the use of large doses of erythropoietin or the use of its analogues that do not affect erythropoiesis can prevent the development of post-infarction cardiac remodeling in humans.

Relationships of illness perception, symptoms response and social support with acute myocardial infarction patients’ prehospital delay in rural China: protocol for a cross-sectional study

IntroductionThe timely treatment of acute myocardial infarction (AMI) patients is of utmost importance, and yet, there remains a significant disparity between urban and rural areas in China due to the...

Gentiopicroside alleviates acute myocardial infarction injury in rats by disrupting Nrf2/NLRP3 signaling.

The objective of the present investigation was to assess the protective impact of gentiopicroside (GPS) on acute myocardial infarction (AMI) through the modulation of NF-E2-related factor 2 (Nrf2)/nucleotide-binding oligomerization domain, leucine-rich repeat, and pyrin domain-containing 3 (NLRP3) signaling. H9c2 cells were subjected to varying concentrations of GPS, and subsequently, the cells and Sprague-Dawley (SD) rats were segregated into control, model, GPS, t-BHQ (an Nrf2 activator), and GPS + ML385 (an Nrf2 inhibitor) groups. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were analyzed. Reactive oxygen species (ROS) and cell apoptosis were assessed, while Nrf2 and the expression of the NLRP3 inflammatory body signal pathway were evaluated using western blot and immunofluorescence techniques. The infarct area and pathological changes were also examined. Treatment with varying doses of GPS resulted in increased viability of H9c2 cells. Notably, the model group exhibited significantly elevated levels of cell apoptosis, MDA, and ROS compared to the control group, while SOD and Nrf2 levels were significantly reduced. Furthermore, the expression of NLRP3, cleaved caspase-1, interleukin (IL)-1β, and IL-18 were found to be augmented. Following the implementation of GPS in cells and animals, there was a notable reduction in MDA and ROS levels, a decrease in the rate of cellular apoptosis, and a mitigation of inflammation scores. In addition, there was an increase in the expression of SOD and Nrf2. However, the protective effects of GPS were negated when co-administered with ML385. GPS exhibits therapeutic properties in AMI rats by activating Nrf2 expression, thereby reducing the NLRP3 inflammatory body and alleviating the inflammatory response and oxidative stress of myocardial cells. GPS may hold promise as a potential drug for the treatment of AMI.

Pathophysiological Mechanisms and Pharmaceutical Interventions of Myocardial Infarction with Depression

Review Pathophysiological Mechanisms and Pharmaceutical Interventions of Myocardial Infarction with Depression Mingyang Xu 1, Yinxiang Wei 2, Zhenhui Wang 1, Yaohui Wang 2, Xiaoming Zhong 3,*, and Qiying Chen 4,* 1 School of medicine, Henan University, Kaifeng 475000, China. 2 Joint National Laboratory for Antibody Drug Engineering, Henan University, Kaifeng 475004, China. 3 Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng 475000, China. 4 Department of Cardiology, Huashan Hospital, Fudan University, Shanghai 200040, China. * Correspondence: Xiaoming Zhong (zxm10020202@126.com); Qiying Chen (chenqiying@huashan.org.cn) Received: 23 March 2023 Accepted: 10 May 2023 Abstract: The strong association between acute myocardial infarction (AMI) and major depression disorder（MDD）is a universally accepted. Patients with AMI complicated by MDD often have poor prognosis. Most early studies focused on how AMI leads to MDD, but there are few reports on depression-induced AMI. In terms of mechanism, inflammation, the hypothalamic-pituitary-adrenal axis (HPA axis) and brain-gut axis may be involved in the occurrence and development of MDD after AMI. The inflammatory injury, abnormal sympathetic and vagal nerve activity, HPA axis overactivation, overeating and some therapeutic medicine administration in patients with MDD can also be risk factors for AMI. Both behavioral and pharmaceutical interventions are important for the treatment of AMI with MDD. More drugs are being developed and tested. At present, there are still many issues, needing to be addressed, in the diagnosis, pathogenesis, intervention strategies and therapeutic drugs for AMI with MDD. To aid clinical diagnosis and treatment, this review classifies the existing studies on AMI complicated with MDD, and also includes some of our considerations.

Reperfusion Induced Fatal Hemorrhagic Myocardial Infarction: A Case Report

Sudden death due to coronary artery disease is the leading cause of death globally. Occlusive coronary artery disease results in ischemia of myocardial tissue and subsequent infarction. Various treatment modalities like blood thinners, percutaneous coronary intervention (PCI) etc are being employed in the treatment of acute myocardial infarction (MI). However, these modalities have their own limitations. In this case, reperfusion therapy resulted in hemorrhagic myocardial infarction (HMI) with a fatal outcome. An adult male with history of sudden collapse was brought to the emergency department, where he was declared as brought dead. He underwent reperfusion therapy and was on blood thinners, 4 days before the incident. On autopsy, we could find the features of hemorrhagic myocardial infarction grossly and the same was confirmed histopathologically. Though reperfusion injuries are commonly documented, deaths due to hemorrhagic myocardial Infarction, which is one of the rare complications of reperfusion therapy, are rarely reported. The important role of forensic pathologists in this case is to identify the rare causes, which led the patient to death during management of occlusive coronary artery disease.

The Signaling Mechanism of Remote Postconditioning of the Heart: Prospects of the Use of Remote Postconditioning for the Treatment of Acute Myocardial Infarction.

Acute myocardial infarction (AMI) remains the leading cause of mortality in the world, highlighting an urgent need for the development of novel, more effective approaches for the treatment of AMI. Remote postconditioning (RPost) of the heart could be a useful approach. It was demonstrated that RPost triggers infarct size reduction, improves contractile function of the heart in reperfusion, mitigates apoptosis, and stimulates autophagy in animals with coronary artery occlusion and reperfusion. Endogenous opioid peptides and adenosine could be involved in RPost. It was found that kinases and NO-synthase participate in RPost. KATP channels, MPT pore, and STAT3 could be hypothetical end-effectors of RPost. Metabolic syndrome and old age abolish the cardioprotective effect of RPost in rats. The data on the efficacy of RPost in clinical practice are inconsistent. These data are discussed in the review.

Role of Tissue Plasminogen Activators, Streptokinase and Other Thrombolytics in the Treatment of Myocardial Infarction

In the United States, coronary artery disease is the most frequently occurring cause of mortality. A century ago, the obstruction of CA was recognized as the root cause of myocardial infarction. Through research, streptokinase was discovered as a beneficial treatment for acute myocardial infarction, lowering mortality. More recent agents, such as tissue plasminogen activators like Tenecteplase, reteplase, and alteplase have also been developed. Today, primary percutaneous coronary intervention and thrombolytic therapy have transformed the way acute myocardial infarction is treated, leading to a significant decrease in cardiovascular-related deaths. This paper offers an outline of the different antifibrinolytic agents used to manage acute myocardial infarction.

Antiplatelet drugs use situation for acute myocardial infarction patients in Vietnam

This study aims to evaluate antiplatelet drug use and possible interactions that can occur during acute myocardial infarction treatment. We establish a cross-sectional descriptive study with 380 acute myocardial infarction inpatient cases treated with antiplatelet drugs in Vietnam in 2021. In our study, the mean age is 69.3, and most patients are over sixty-five, accounting for 67.6%. Indicated antiplatelet drugs encompass aspirin (100%), clopidogrel (86.0%), and ticagrelor (42.6%). Dual antiplatelet therapy with aspirin-clopidogrel and aspirin-ticagrelor accounts for 86.0% and 42.6%, respectively. According to drugs.com and medscape.com, the results show three clinically significant combinations:aspirin-enalapril (37.4%), clopidogrel-esomeprazole (31.3%), and aspirin-captopril (20%). Of all discovered drug interactions, 28.1% are estimated as major and 38.8% as moderate (monitor closely). The results show that aspirin is considered the first-line drug, and the aspirin-clopidogrel combination is more common than aspirin-ticagrelor in the treatment of acute myocardial infarction patients. Aspirin-enalapril, clopidogrelesomeprazole, and aspirin-captopril are clinically significant interactions avoided in indicating.

Comparison of Percutaneous Coronary Intervention Procedures and Outcomes for Recent and Acute ST-Elevation Myocardial Infarction.

Although the primary percutaneous coronary intervention (PCI) is an established treatment for acute ST-elevation myocardial infarction (STEMI), relevant guidelines do not recommend it for recent-STEMI cases with a totally occluded infarcted related artery (IRA). However, PCI is allowed in Japan for recent-STEMI cases, but little is known regarding its outcomes. We aimed to examine the details and outcomes of PCI procedures in recent-STEMI cases with a totally occluded IRA and compared the findings with those in acute-STEMI cases.Among the 903 consecutive patients admitted with acute coronary syndrome, 250 were treated with PCI for type I STEMI with a totally occluded IRA. According to the time between symptom onset and diagnosis, patients were divided into the recent-STEMI (n = 32) and acute-STEMI (n = 218) groups. The background, procedure details, and short-term outcomes were analyzed. No significant differences between the groups were noted regarding patient demographics, acute myocardial infarction severity, or IRA distribution. Although the stent number and type were similar, significant differences were observed among PCI procedures, including the number of guidewires used, rate of microcatheter or double-lumen catheter use, and application rate of thrombus aspiration. The thrombolysis rate in the myocardial infarction flow 3-grade post-PCI did not differ significantly between the groups. Both groups had a low frequency of procedure-related complications. The in-hospital mortality rates were 0% and 4.6% in the recent-STEMI and acute-STEMI groups, respectively (P > 0.05).Although recent-STEMI cases required complicated PCI techniques, their safety, success rate, and in-hospital mortality were comparable to those of acute-STEMI cases.

Facile fabrication of biocompatible injectable blended polymeric hydrogel with bioactive nanoformulation to improving cardiac tissue regeneration efficiency after myocardial infarction for nursing care potential applications

Recent years, cardiac vascular disease has arisen owing to acute myocardial infarction (MI) and heart failure leading to death worldwide. Various treatments are available for MI in modern medicine such as implantation of devices, pharmaceutical therapy, and transplantation of organs, nonetheless, it has many complications in finding an organ donor, devices for stenosis, high intrusiveness and long-time hospitalization. To overcome these problems, we have designed and developed a novel hydrogel material with a combination of Se NPs loaded poly(ethylene glycol)/tannic acid (PEG/TA) hydrogel for the treatment of acute MI repair. Herein, Se NPs were characterized by effective analytical and spectroscopic techniques. In vitro cell compatibility and anti-oxidant analyses were examined on human cardiomyocytes in different concentrations of Se NPs and appropriate Se NPs loaded hydrogel samples to demonstrate its greater suitability for in vivo cardiac applications. In vivo investigations of MI mice models injected with Se hydrogels established that LV wall thickness was conserved significantly from the value of 235.6 µm to 390 µm. In addition, the relative scar thickness (33.6%) and infarct size (17.1%) of the MI model were enormously reduced after injection of Se hydrogel when compared to the Se NPs and control (MI) sample, respectively, which confirmed that Se introduced hydrogel have greatly influenced on the restoration of the infarcted heart. Based on the investigated results of the nanoformulation samples, it could be a promising material for future generations treatment of acute myocardial infarction and cardiac repair applications.

The impact of the COVID-19 Pandemic on Emergency Care of Acute Myocardial Infarction: Findings from the Taiwan Clinical Performance Indicator (TCPI).

Acute myocardial infarction (AMI) treatment requires timely diagnosis and treatment for optimal health outcomes. The COVID-19 pandemic has caused changes in healthcare delivery and utilisation; therefore, our study explored the changes in emergency care quality indicators for patients with AMI before and during different periods of government response to the COVID-19 outbreak in Taiwan. The Taiwan Clinical Performance Indicators (TCPI) database was used to evaluate the impact of COVID-19 on acute care quality indicators for patients with AMI during four periods: before the COVID-19 outbreak (Period I, 1 January to 31 December 2019) and during three periods in which the central government imposed different levels of epidemic prevention and response alerts (Period II, 1 January 2020, to 30 April 2021; Period III, 1 May to 31 July 2021; and Period IV, 1 August to 31 December 2021) . A 15.9% decrease in monthly emergency department admission for patients with AMI occurred during Period III. The hospital "door-to-electrocardiogram time being <10 min" indicator attainment was significantly lower during Periods III and IV. The attainment of "dual antiplatelet therapy (DAPT) received within 6 hours of emergency department arrival" indicator improved in Period IV, whereas "the primary percutaneous coronary intervention (PCI) being received within 90 min of hospital arrival" indicator significantly decreased during Periods III and IV. The indicator "in-hospital mortality" was unchanged within our study duration. Overall, the quality of care for patients with AMI was mildly influenced during the assessed pandemic periods, especially in terms of door-to- electrocardiogram times of <10 min and primary PCI received within 90 min of hospital arrival (Period III). Using our study results, hospitals can develop strategies regarding care delivery for patients with AMI during a COVID-19 outbreak on the basis of central government alert levels, even during the height of the pandemic.

A biomarker discovery of acute myocardial infarction using feature selection and machine learning.

Acute myocardial infarction (AMI) or heart attack is a significant global health threat and one of the leading causes of death. The evolution of machine learning has greatly revamped the risk stratification and death prediction of AMI. In this study, an integrated feature selection and machine learning approach was used to identify potential biomarkers for early detection and treatment of AMI. First, feature selection was conducted and evaluated before all classification tasks with machine learning. Full classification models (using all 62 features) and reduced classification models (using various feature selection methods ranging from 5 to 30 features) were built and evaluated using six machine learning classification algorithms. The results showed that the reduced models performed generally better (mean AUPRC via random forest (RF) algorithm for recursive feature elimination (RFE) method ranges from 0.8048 to 0.8260, while for random forest importance (RFI) method, it ranges from 0.8301 to 0.8505) than the full models (mean AUPRC via RF: 0.8044). The most notable finding of this study was the identification of a five-feature model that included cardiac troponin I, HDL cholesterol, HbA1c, anion gap, and albumin, which had achieved comparable results (mean AUPRC via RF: 0.8462) as to the models that containing more features. These five features were proven by the previous studies as significant risk factors for AMI or cardiovascular disease and could be used as potential biomarkers to predict the prognosis of AMI patients. From the medical point of view, fewer features for diagnosis or prognosis could reduce the cost and time of a patient as lesser clinical and pathological tests are needed.

P66 PROGNOSTIC IMPACT OF PERCUTANEOUS CORONARY INTERVENTION IN ACUTE MYOCARDIAL INFARCTION PATIENTS OLDER THAN 75 YEARS. REAL–WORLD FINDINGS FROM THE LOMBARDY REGION

Abstract Background Older patients, generally defined as individuals age &amp;gt;75 years, are less likely to receive percutaneous coronary intervention (PCI) for treatment of acute myocardial infarction (AMI) compared to younger patients. This is due to the paucity of evidence derived from randomized trials, concerns about possible PCI–related side effects, and multimorbidity. We investigated the prognostic impact of PCI in a large population of patients hospitalized with AMI in the period 2003–2018, by using the administrative Lombardy Health Database. Methods We analyzed data of all patients &amp;gt;75 years hospitalized with AMI (both STEMI and NSTEMI) from 2003 to 2018 in Lombardy. Patients were grouped according to whether they were treated or not with PCI during index hospitalization. The primary outcome was in–hospital mortality. One–year mortality and 1–year re–hospitalization for acute heart failure (AHF) or AMI were considered as secondary endpoints. Results During the study period, 116,063 patients (mean age 83±6; 48% males; 46% STEMI) were hospitalized with a primary diagnosis of AMI. Thirty–seven percent of them (n=42,912) were treated with PCI. The in–hospital mortality rate in the entire cohort was 12%. It was significantly lower in patients treated with PCI than in those not treated with PCI (6% vs. 15%; P&amp;lt;0.0001). In the overall population, 1–year mortality was 32% and 1–year re–hospitalization for AHF/AMI was 19%. Both these endpoints were less frequent in PCI–treated patients (16% vs. 41% and 15% vs. 21%, respectively; P&amp;lt;0.0001). The adjusted risk of the study endpoints was significantly lower in patients treated with PCI: OR 0.37 (95% CI 0.36–0.39) for in–hospital mortality; HR 0.37 (95% CI 0.36–0.38) for 1–year mortality; HR 0.74 (95% CI 0.71–0.77) for 1–year re–hospitalization for AHF/AMI. Similar results were found in STEMI and NSTEMI patients considered separately. Conclusions Our real–world data showed that in patients with AMI &amp;gt;75 years of age, PCI use is associated with a significantly lower in–hospital mortality and up to 1 year. This work was partly financed by the Italian Ministry of Health and the Lombardia Region (Grant NET–2016–02364191; EASY–NET)

C22 PROGNOSTIC IMPACT OF PERCUTANEOUS CORONARY INTERVENTION IN CHRONIC DIALYSIS PATIENTS WITH ACUTE MYOCARDIAL INFARCTION: FINDINGS FROM THE LOMBARDY HEALTH DATABASE

Abstract Background Patients on chronic dialysis are less likely to receive percutaneous coronary intervention (PCI) for treatment of acute myocardial infarction (AMI). This is due to the lack of evidence from randomized trials, concerns about possible PCI–related side effects, and multimorbidity. Thus, routine use of PCI for treatment of dialysis patients with AMI remains an unresolved issue. Methods We analyzed data of patients on chronic dialysis hospitalized with AMI (both ST–elevation myocardial infarction [STEMI] and non–ST–elevation myocardial infarction [NSTEMI]) from 2003 to 2018, by using the administrative Lombardy Health Database (Italy). Patients were grouped according to whether they were treated or not with PCI during hospitalization. The primary outcome was in–hospital mortality while 1–year mortality was the secondary endpoint. Results During the study period, 265,048 patients were hospitalized with AMI in Lombardy. Of them, 3,206 (1.2%) were on chronic dialysis (age 71±11; 72% males). Among dialysis patients, 44% were treated with PCI, while 54% underwent PCI among non–dialysis patients (P&amp;lt;0.0001). Dialysis was an independent predictor of conservative treatment with medical therapy only (OR 0.75 [95% CI 0.70–0.81]). In–hospital mortality in the dialysis cohort was 15%. It was significantly lower in patients treated with PCI than in those not treated with PCI (11% vs. 19%; P&amp;lt;0.0001). One–year mortality was 47% and it was lower in PCI–treated patients (33% vs. 52%; P&amp;lt;0.0001). The adjusted risk of the study endpoints was significantly lower in dialysis patients treated with PCI: OR 0.62 (95% CI 0.50–0.76) for in–hospital mortality; HR 0.63 (95% CI 0.56–0.71) for 1–year mortality. Similar results were found in STEMI and NSTEMI patients considered separately. Conclusions Our real–world data showed that in patients with AMI on chronic dialysis, PCI use is associated with a significant in–hospital and 1–year survival benefit. This work was partly financed by the Italian Ministry of Health and the Lombardia Region (Grant NET–2016–02364191; EASY–NET)

Sestrin2 levels in patients with anxiety and depression myocardial infarction was up-regulated and suppressed inflammation and ferroptosis by LKB1-mediated AMPK activation

ABSTRACT Although great progress has been made in the diagnosis and treatment of acute myocardial infarction (AMI) in recent years, its morbidity and mortality are still relatively high. In this study, we explain that the function of Sestrin2 gene in Anxiety and Depression Myocardial infarction and its possible mechanism. 26 patients with Anxiety and Depression Myocardial infarction (ADMI) and 26 normal volunteers were collected from our hospital. All mice anaesthetized using 50 mg/kg of pentobarbital sodium and the left anterior descending arteries (LAD) were ligated to induce myocardial infarction. H9c2 cells were stimulated with 5% oxygen (O2) and 5% carbon dioxide (CO2) and 90% N2 for 24 h. The serum expression of Sestrin2 in patients with ADMI was up-regulated. Sestrin2 gene up-regulation reduced collagen I/II and KEAP1 mRNA expressions, and increased GPX4 and Nrf2 mRNA expressions in vitro model of AMI. Down-regulation of Sestrin2 increased collagen I/II and KEAP1 mRNA expressions, and decreased GPX4 and Nrf2 mRNA expressions in vitro model of AMI. These data confirmed that Sestrin2 reduced inflammation and ferroptosis in model of ADMI by LKB1-mediated AMPK activation. This infers that Sestrin2 is potential target to be used in the treatment of premature AMI.

Stable isotope labeling differential glycans discovery in the serum of acute myocardial infarction by ultrahigh-performance liquid chromatography-quadrupole-Orbitrap high resolution mass spectrometry

Acute myocardial infarction (AMI) poses a grave threat to human life. However, most clinical biomarkers have limitations of low sensitivity and specificity. Therefore, screening novel glycan biomarkers with high sensitivity and specificity is crucial for the prevention and treatment of AMI. The novel method of ultrahigh-performance liquid chromatography coupled to quadrupole-Orbitrap high-resolution mass spectrometry (UHPLC-Q-Orbitrap HRMS) with d0/d5-BOTC probe labeling for relative quantification of glycans based on Pronase E digestion was established to screen novel glycan biomarkers in the serum of 34 AMI patients relative to healthy volunteers. The monosaccharide model D-glucosamine was used to investigate the effectiveness of the derivatization; the limit of detection (S/N = 3) was 10 amol. The accuracy was verified based on the consistency of different theoretical molar ratios (d0/d5 = 1:2, 2:1) and intensity ratios following digestion of glycoprotein ribonuclease B. Expressions of H4N4F3SA, H4N6F2, H4N6SA, H4N6F3 and H5N4FSA in the serum were significantly different (p < 0.0005) between AMI patients and healthy volunteers. The area under the receiver operating characteristic curve (AUC) for H4N6SA, H5N4FSA, and H4N6F2 was greater than 0.9039. Based on the proposed method, H4N6SA, H5N4FSA, and H4N6F2 in human serum showed high accuracy and specificity and may serve as potential glycan biomarkers, crucial for the diagnosis and treatment monitoring of AMI.