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2. The Role of Inflammation in Early Left Ventricular Thrombus Formation Following ST‐Elevation Myocardial Infarction—A Matched Case‐Control Study.

Author

Litmanowicz, Batia, Perelman, Moran Gvili, Laufer‐Perl, Michal, Topilsky, Yan, Banai, Shmuel, Shacham, Yacov, and Khoury, Shafik

Subjects
LEUKOCYTE count, CORONARY care units, CARDIAC intensive care, INTENSIVE care units, ST elevation myocardial infarction
Abstract

Background: There is limited data on the association between inflammation and the formation of early left ventricular thrombus (LVT) following ST‐elevation myocardial infarction (STEMI). This study aimed to explore the predictive value of several inflammatory biomarkers for LVT formation following STEMI. Methods and Results: Our cohort included 2534 consecutive patients admitted to the cardiac intensive care unit (CICU) with STEMI. The final analysis included 51 patients with LVT and 102 patients without LVT, matched for age, sex, anterior infarct and ejection fraction. Upon admission, patients with LVT had higher white blood cell counts (WBC) (12.8 ± 7 vs. 12.4 ± 4 ×103/µL, p = 0.01), higher absolute neutrophil counts (10.5 ± 4 vs. 8.6 ± 4 ×103/µL, p = 0.003), neutrophil‐to‐lymphocyte ratio (8.2 ± 6 vs. 4.8 ± 4, p = 0.04), and C‐reactive protein (CRP) levels (35.9 ± 62 vs. 18.6 ± 40 mg/L, p = 0.04). Peak values for WBC and CRP were also higher in the LVT group (17.8 ± 8 vs. 14.6 ± 5 ×103/µL, p = 0.003 and 95.8 ± 82 vs. 64.2 ± 76 mg/L, p = 0.02, respectively). In univariate regression analysis, WBC upon admission (OR: 1.12, 95% CI: 1.02–1.21, p = 0.02), peak WBC (OR: 1.09, 95% CI: 1.02–1.17, p = 0.009), neutrophil count upon admission (OR: 1.15, 95% CI: 1.04–1.26, p = 0.004), and peak CRP (OR: 1.01, 95% CI: 1–1.01, p = 0.03) predicted LVT formation, which was also evident in multivariate regression models. Conclusion: WBC and neutrophil counts upon admission, as well as peak WBC and CRP, have additional predictive value for LVT formation following STEMI, beyond classical risk factors. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Persistent Renal Dysfunction After Acute Kidney Injury Among STEMI Patients Undergoing Primary Coronary Intervention: Prevalence and Predictors.

Author

Frydman, Shir, Freund, Ophir, katash, Haytham Abu, Rimbrot, Daniel, Banai, Shmuel, and Shacham, Yacov

Subjects
MYOCARDIAL infarction, ACUTE kidney failure, CHRONIC kidney failure, KIDNEY diseases, ST elevation myocardial infarction
Abstract

Background: Acute kidney injury (AKI) is a common and serious complication of ST‐elevation myocardial infarction (STEMI). AKI and chronic kidney disease (CKD) are highly heterogeneous, leaving a wide gap between them. Therefore, the term acute kidney disease (AKD) was implemented, describing prolonged renal injury between 7 and 90 days. We aimed to evaluate the prevalence and predictors of AKD among STEMI patients. Methods: This retrospective observational study included 2940 consecutive patients admitted with STEMI between 2008 and 2022. Renal function was assessed upon admission and routinely thereafter. Renal outcomes were evaluated according to KDIGO criteria, with AKD defined as persistent renal injury of between 7 and 90 days. Results: Two hundred and fifty‐two subjects with STEMI and AKI were included; of them, 117 (46%) developed AKD. Among baseline CKD patients, higher rates of AKD were observed (60% vs. 46%). KDIGO index ≥ 2 was an independent predictor for AKD in in subjects without baseline CKD (AOR 2.63, 95% CI 1.07−6.53). In subjects with baseline CKD, older age and higher creatinine were independent predictors for AKD. Subjects with AKD had a higher 1‐year mortality rate (HR 3.39, 95% CI 1.71−6.72, p < 0.01). This trend was mainly driven by the CKD subpopulation where higher mortality rates for AKD on CKD were observed (HR 5.26, 95% CI 1.83−15.1, p < 0.01). Conclusion: AKD is common among STEMI patients with AKI. The presence of CKD and higher KDIGO stage should prompt strict monitoring for early diagnosis, treatment, and prevention of renal function deterioration. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Early neutrophil gelatinase‐associated lipocalin (NGAL) measurement could rule out future acute kidney injury in patients with acute coronary syndrome—Prospective observational study.

Author

Magnusson, Nils Erik, Frydman, Shir, Freund, Ophir, Zornizki, Lior, Banai, Shmuel, and Shacham, Yacov

Subjects
LIPOCALIN-2, ACUTE kidney failure, ACUTE coronary syndrome, LONGITUDINAL method, SCIENTIFIC observation
Abstract

Background and Aims: The diagnosis of acute kidney injury (AKI) is of importance among patients with ST segment elevation (STEMI) undergoing primary coronary intervention (PCI). It is often delayed given the need in serial measurements of creatinine or other serum markers. Neutrophil gelatinase‐associated lipocalin (NGAL) is a proven marker for AKI, although its role as an early predictor in this setting was scarcely addressed before and was the aim of our study. Methods: Prospective observational study including 133 patients with STEMI treated with PCI. Plasma NGAL was drawn immediately before PCI (NGAL‐0) and 24 h after (NGAL‐24). Similar analysis of C‐reactive protein (CRP) was performed for additional comparison. Results: Mean age was 62 ± 13 years, 78% were men, and 20 (15%) developed AKI after admission. Patients with AKI after admission demonstrated higher levels of NGAL‐0 (164 vs. 95 ng/mL; p < 0.001) and NGAL‐24 (142 vs. 93 ng/mL; p < 0.001). Levels of NGAL‐0 and NGAL‐24 were similar within the AKI and non‐AKI groups. Using ROC curve analysis, NGAL‐0 had best predictive ability for AKI development (AUC 0.841, 95% CI 0.80–0.96), compared with NGAL‐24 (0.783, 95% CI 0.74–0.85), CRP‐0 (0.701, 95% CI 0.58–0.83), and CRP‐24 (0.781, 95% CI 0.66–0.90). The optimal NGAL‐0 cutoff for AKI prediction was 125 ng/mL, with 70% sensitivity, 84% specificity, and 94% negative predictive value. Conclusions: Among STEMI patients, NGAL measurement upon admission are associated with AKI and may serve as a reliable marker for early AKI detection. Future studies may direct risk stratification using this single test can direct personalized evaluations during the admission, and focused interventions to prevent AKI. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Patients with ST-Elevation Myocardial Infarction and Its Association with Acute Kidney Injury and Mortality

Author

Højagergaard, Mathias Alexander, primary, Beske, Rasmus Paulin, additional, Hassager, Christian, additional, Holmvang, Lene, additional, Jensen, Lisette Okkels, additional, Shacham, Yacov, additional, Meyer, Martin Abild Stengaard, additional, Moeller, Jacob Eifer, additional, Helgestad, Ole Kristian Lerche, additional, Mark, Peter Dall, additional, Møgelvang, Rasmus, additional, and Frydland, Martin, additional

Published
2023
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11. Sex differences in heart failure patients assessed by combined echocardiographic and cardiopulmonary exercise testing

Author

Rozenbaum, Zach, primary, Granot, Yoav, additional, Sadeh, Ben, additional, Havakuk, Ofer, additional, Arnold, Joshua H., additional, Shimiaie, Jason, additional, Ghermezi, Michael, additional, Barak, Orly, additional, Ben Gal, Yanai, additional, Shacham, Yacov, additional, Keren, Gad, additional, Topilsky, Yan, additional, and Laufer-Perl, Michal, additional

Published
2023
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12. Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Patients with ST-Elevation Myocardial Infarction and Its Association with Acute Kidney Injury and Mortality

Author

Højagergaard, Mathias Alexander, Beske, Rasmus Paulin, Hassager, Christian, Holmvang, Lene, Jensen, Lisette Okkels, Shacham, Yacov, Meyer, Martin Abild Stengaard, Moeller, Jacob Eifer, Helgestad, Ole Kristian Lerche, Mark, Peter Dall, Møgelvang, Rasmus, Frydland, Martin, Højagergaard, Mathias Alexander, Beske, Rasmus Paulin, Hassager, Christian, Holmvang, Lene, Jensen, Lisette Okkels, Shacham, Yacov, Meyer, Martin Abild Stengaard, Moeller, Jacob Eifer, Helgestad, Ole Kristian Lerche, Mark, Peter Dall, Møgelvang, Rasmus, and Frydland, Martin

Abstract

Neutrophil gelatinase-associated lipocalin (NGAL) is an inflammatory biomarker related to acute kidney injury (AKI). Including 1892 consecutive patients with ST-elevation myocardial infarction (STEMI), in which NGAL was measured in 1624 (86%) on admission and in a consecutive subgroup at 6–12 h (n = 163) and 12–24 h (n = 222) after admission, this study aimed to evaluate the prognostic value of NGAL in predicting AKI and mortality. Patients were stratified based on whether their admission NGAL plasma concentration was greater than or equal to/less than the median. The primary endpoint was a composite of the first occurrence of AKI or all-cause death within 30 days. AKI was classified by the maximal plasma creatinine increase from baseline during index admission as KDIGO1 (<200% increase) or KDIGO23 (≥200% increase) according to the Kidney Disease Improving Global Outcomes (KDIGO) system. Admission NGAL > the median was independently associated with a higher risk of severe AKI (KDIGO2-3) and 30-day all-cause mortality when adjusted for age, admission systolic blood pressure and high-sensitivity C-reactive protein, left-ventricular ejection fraction, known kidney dysfunction, and cardiogenic shock with an odds ratio (95% confidence interval) of 2.26 (1.18–4.51), p = 0.014. Finally, we observed increasing predictive values in a subgroup during the first day of hospitalization suggesting that assessment of NGAL should be delayed for optimal prognostic purposes., Neutrophil gelatinase-associated lipocalin (NGAL) is an inflammatory biomarker related to acute kidney injury (AKI). Including 1892 consecutive patients with ST-elevation myocardial infarction (STEMI), in which NGAL was measured in 1624 (86%) on admission and in a consecutive subgroup at 6–12 h (n = 163) and 12–24 h (n = 222) after admission, this study aimed to evaluate the prognostic value of NGAL in predicting AKI and mortality. Patients were stratified based on whether their admission NGAL plasma concentration was greater than or equal to/less than the median. The primary endpoint was a composite of the first occurrence of AKI or all-cause death within 30 days. AKI was classified by the maximal plasma creatinine increase from baseline during index admission as KDIGO1 (<200% increase) or KDIGO23 (≥200% increase) according to the Kidney Disease Improving Global Outcomes (KDIGO) system. Admission NGAL > the median was independently associated with a higher risk of severe AKI (KDIGO2-3) and 30-day all-cause mortality when adjusted for age, admission systolic blood pressure and high-sensitivity C-reactive protein, left-ventricular ejection fraction, known kidney dysfunction, and cardiogenic shock with an odds ratio (95% confidence interval) of 2.26 (1.18–4.51), p = 0.014. Finally, we observed increasing predictive values in a subgroup during the first day of hospitalization suggesting that assessment of NGAL should be delayed for optimal prognostic purposes.

Published
2023

25. Immediate and early percutaneous coronary intervention in very high‐risk and high‐risk non‐ST segment elevation myocardial infarction patients

Author

Lupu, Lior, primary, Taha, Louay, additional, Banai, Ariel, additional, Shmueli, Hezzy, additional, Borohovitz, Ariel, additional, Matetzky, Shlomi, additional, Gabarin, Mustafa, additional, Shuvy, Mony, additional, Beigel, Roy, additional, Orvin, Katia, additional, Minha, Sa'ar, additional, Shacham, Yacov, additional, Banai, Shmuel, additional, Glikson, Michael, additional, and Asher, Elad, additional

Published
2022
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29. The Cardio-Hepatic Relation in STEMI

Author

Bannon, Lian, primary, Merdler, Ilan, additional, Bar, Nir, additional, Lupu, Lior, additional, Banai, Shmuel, additional, Jacob, Giris, additional, and Shacham, Yacov, additional

Published
2021
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30. Relation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients

Author

Lupu, Lior, primary, Abukatash, Hytham, additional, Banai, Ariel, additional, Rozenfeld, Keren-Lee, additional, Lewit, Dana, additional, Merdler, Ilan, additional, Loewenstein, Itamar, additional, Bornstein, Gil, additional, Banai, Shmuel, additional, and Shacham, Yacov, additional

Published
2021
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35. Acute myocardial infarction in the Covid-19 era: Incidence, clinical characteristics and in-hospital outcomes—A multicenter registry

Author

Fardman, Alexander, primary, Zahger, Doron, additional, Orvin, Katia, additional, Oren, Daniel, additional, Kofman, Natalia, additional, Mohsen, Jameel, additional, Tsafrir, Or, additional, Asher, Elad, additional, Rubinshtein, Ronen, additional, Jamal, Jafari, additional, Efraim, Roi, additional, Halabi, Majdi, additional, Shacham, Yacov, additional, Fortis, Lior Henri, additional, Cohen, Tal, additional, Klempfner, Robert, additional, Segev, Amit, additional, Beigel, Roy, additional, and Matetzky, Shlomi, additional

Published
2021
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38. Detection of Renal Injury Following Primary Coronary Intervention among ST-Segment Elevation Myocardial Infarction Patients: Doubling the Incidence Using Neutrophil Gelatinase-Associated Lipocalin as a Renal Biomarker

Author

Lupu, Lior, primary, Rozenfeld, Keren-Lee, additional, Zahler, David, additional, Morgan, Samuel, additional, Merdler, Ilan, additional, Shtark, Moshe, additional, Goldiner, Ilana, additional, Banai, Shmuel, additional, and Shacham, Yacov, additional

Published
2021
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40. Unknown Subclinical Hypothyroidism and In-Hospital Outcomes and Short- and Long-Term All-Cause Mortality among ST Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

Author

Izkhakov, Elena, primary, Zahler, David, additional, Rozenfeld, Keren-Lee, additional, Ravid, Dor, additional, Banai, Shmuel, additional, Topilsky, Yan, additional, Stern, Naftali, additional, Greenman, Yona, additional, and Shacham, Yacov, additional

Published
2020
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49. ABSENCE OF CLINICAL TRIGGERING IN DIABETIC PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION PREDICTS MULTIPLE VESSEL CORONARY DISEASE AND IS ASSOCIATED WITH INCREASED MORTALITY

Author

Ben-Shoshan, Jeremy, primary, Zahler, David, additional, Segman-Rosenstveig, Yafit, additional, Arbel, Yaron, additional, Chorin, Ehud, additional, Barkagan, Michael, additional, Rozenbaum, Zach, additional, Granot, Yoav, additional, Finkelstein, Ariel, additional, Banai, Shmuel, additional, Keren, Gad, additional, Shacham, Yacov, additional, and Konigstein, Maayan, additional

Published
2017
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