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Objectives: Secondary prevention is crucial for reducing morbidity and mortality in patients following acute myocardial infraction (MI). However, adherence to cardiac rehabilitation (CR) and pharmacotherapy remains suboptimal despite strong guideline recommendations. This study investigated the adherence to CR, dual antiplatelet therapy (DAPT), and statins following acute MI and evaluated their impact on patient outcomes from a nationwide perspective in Austria. Methods: In this national observational study, all patients diagnosed with acute MI, defined as STEMI or NSTEMI, between April 2011 and August 2015 in Austria were included. Patient characteristics and comorbidities were derived from the Austrian national health insurance system using ICD-10 codes. Adherence to CR, high-intensity statins, and DAPT was assessed based on health insurance records and pharmacy prescription submissions. Cox Regression hazard analysis was used to explore the impact of non-adherence to CR on mortality. Results: Among 16,518 acute MI patients, only 13.4% adhered to the recommended CR programs, which was associated with a significantly lower risk of mortality (adjusted hazard ratio [HR] 0.73; 95% CI: 0.54–0.98; p = 0.036). In contrast, 66.4% of 23,240 patients did not comply with high-intensity statin therapy, correlating with an increased mortality risk (adjusted HR 1.16; 95% CI: 1.06–1.25; p < 0.001). Furthermore, among 22,331 patients analyzed for DAPT adherence, only 29.3% followed the guidelines, yet this adherence was linked to a 21% reduction in mortality over the observation period (adjusted HR 0.79; 95% CI: 0.72–0.88; p < 0.001). Conclusions: This nationwide study reveals alarmingly low adherence to CR and secondary preventive medications among acute MI patients, which is significantly linked to higher mortality rates. Enhanced efforts to promote awareness and adherence are crucial, involving structured referrals and personalized follow-ups to improve patient outcomes. Addressing these gaps through comprehensive healthcare strategies could substantially enhance cardiovascular health. [ABSTRACT FROM AUTHOR]

The editorial in Circulation discusses the significant mortality rate associated with acute myocardial infarction complicated by cardiogenic shock (AMI-CS) despite medical advancements. The focus of care for cardiogenic shock has expanded to include noncardiac organ involvement, such as acute kidney injury (AKI), which is associated with higher mortality rates. The study highlights the use of a micro-axial flow pump in patients with AMI-CS and its impact on AKI, emphasizing the need for further research to improve outcomes for critically ill patients. [Extracted from the article]

Temporary mechanical circulatory support as well as multidisciplinary team approach in a regional care organization might improve survival of cardiogenic shock. No study has evaluated the relative effect of each temporary mechanical circulatory support on mortality in the context of a regional network. Prospective observational data were retrieved from patients consecutively admitted with cardiogenic shock to the intensive care units in 3 centers organized into a regional cardiac assistance network. Temporary mechanical circulatory support indication was decided by a heart team, based on the initial shock severity or if shock was refractory to medical treatment within 24 hours of admission. A propensity score for circulatory support use was used as an adjustment co-variable to emulate a target trial. The primary endpoint was in-hospital mortality. Two hundred and forty-six patients were included in the study (median age: 59.5 years, 71.9% male): 121 received early mechanical assistance. The main etiologies were acute myocardial infraction (46.8%) and decompensated heart failure (27.2%). Patients who received early mechanical assistance had more severe conditions than other patients. Their crude in-hospital mortality was 38% and 22.4% in other patients but adjusted in-hospital mortality was not different (hazard ratio 0.91, 95% CI:0.65–1.26). Patients with mechanical assistance had a higher rate of complications than others with longer Intensive Care Unit and hospital stays. In the conditions of a cardiac assistance regional network, in-hospital mortality was not improved by early mechanical assistance implantation. A high incidence of complications of temporary mechanical circulatory support may have jeopardized its potential benefit. [ABSTRACT FROM AUTHOR]

Background: Red cell distribution width (RDW) is an important parameter that has a critical impact on the severity of coronary artery disease, especially on that of acute myocardial infarctioni(AMI). Objective: study was to assess the correlation between red cell distribution width and left ventricular ejection fraction in patients presenting with acute myocardial infarction. Methods: Study was conducted on 110 patients admitted at tertiary care centre with acute myocardial infarction satisfying inclusion criteria. Detailed history and clinical examination was done. RDW and other CBC parameters were calculated by an automatic blood counter and measurement of LVEF done by 2D-echocardiography. Results: Out of 110 patients of acute myocardial infarction 86 were male and 24 were female. Both RDW and LVEF are linked in patients of acute myocardial infarctions, as there was statistically significant correlation between high RDW and low LVEF. Conclusions: It is observed that increase RDW and decrease LVEF were linked together which is statistically significant. [ABSTRACT FROM AUTHOR]

Intranasal (IN) administration has emerged as a novel approach for rapid systemic absorption, with potential applicability in the management of acute cardiovascular events. This review explores the evolution of IN cardiovascular pharmacotherapy, emphasizing its potential in achieving systemic effects and bypassing the first-pass metabolism associated with oral administration. The extensive vascularization of nasal mucosa and a porous endothelial basement membrane facilitate efficient drug absorption into the bloodstream. The IN route ensures a critical swift onset of action, which allows self-administration in at-home settings. For instance, etripamil nasal spray, a first-in-class formulation, exemplifies the therapeutic potential of this approach in the treatment of spontaneous supraventricular tachycardia. The review critically assesses studies on IN formulations for angina, acute myocardial infarction, hypertensive episodes, and cardiac arrhythmias. Preclinical evaluations of beta-blockers, calcium-channel blockers, and antianginal drugs demonstrate the feasibility of IN administration for acute cardiovascular events. A small number of clinical trials have revealed promising results, emphasizing the superiority of IN drug delivery over oral administration in terms of bioavailability and onset of action. Unambiguously, the limited clinical trials and patient enrollment pose challenges in generalizing experimental outcomes. However, the nose-to-heart approach has clinical potential. [ABSTRACT FROM AUTHOR]

Background: Red cell distribution width (RDW) is an important parameter that has a critical impact on the severity of coronary artery disease, especially on that of acute myocardial infarction (AMI). Objective: study was to assess the correlation between red cell distribution width and left ventricular ejection fraction in patients presenting with acute myocardial infarction. Methods: Study was conducted on 110 patients admitted at tertiary care centre with acute myocardial infarction satisfying inclusion criteria. Detailed history and clinical examination was done. RDW and other CBC parameters were calculated by an automatic blood counter and measurement of LVEF done by 2D-echocardiography. Results: Out of 110 patients of acute myocardial infarction 86 were male and 24 were female. Both RDW and LVEF are linked in patients of acute myocardial infarctions, as there was statistically significant correlation between high RDW and low LVEF. Conclusion: It is Observed that Increase in RDW Associated with decrease in Left Ventricular Ejection Fraction in Patient of CAD Which Is Statistically Significant So RDW can be used to Assess Severity in Patient with Acute Myocardial Infraction. [ABSTRACT FROM AUTHOR]

The 66‐year‐old woman was diagnosed with "acute myocardial infarction" due to acute triple vessel occlusion based on clinical symptoms, laboratory examination, and coronary angiography (CAG), but her ECG showed ST‐segment depression in leads aVR and aVL, in addition to ST‐segment elevation in a wide range of leads (V1–V9, V3R–V5R, II, III, and aVF). Thus, a perfect explanation with the existing theory is difficult, and only the case is presented here. [ABSTRACT FROM AUTHOR]

Abstract The 66‐year‐old woman was diagnosed with “acute myocardial infarction” due to acute triple vessel occlusion based on clinical symptoms, laboratory examination, and coronary angiography (CAG), but her ECG showed ST‐segment depression in leads aVR and aVL, in addition to ST‐segment elevation in a wide range of leads (V1–V9, V3R–V5R, II, III, and aVF). Thus, a perfect explanation with the existing theory is difficult, and only the case is presented here.

Lei Liu,1 Xiaoyan Liu,1 Xiaosong Ding,1 Hui Chen,1 Hongwei Li1– 3 1Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, People’s Republic of China; 3Department of Geriatrics, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Hongwei Li, Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, People’s Republic of China, Tel +8613801396679, Email lhw19656@sina.com; 15810176037@mail.ccmu.edu.cnBackground: The “obesity paradox” has not been elucidated in the long-term outcomes in acute myocardial infarction (AMI) patients. This study sought to characterize the relationship between body mass index (BMI) and the risk of new-onset atrial fibrillation (NOAF).Methods: A total of 4282 participants free from AF at baseline were identified at Beijing Friendship Hospital. Baseline body mass index (BMI) was categorized into four groups. Incidence of NOAF was observed at the follow-up visits. The associations between different BMI categories and the incidence of NOAF were assessed by multivariate Cox regression analysis.Results: Over a median follow-up period of 42.0 months, 4282 participants (age 62.7 ± 6.6 years, 38.7% women) were enrolled, 23.0% were BMI < 23.0kg/m2, 22.5% were 23.0– 24.9 kg/m2, 44.3% were 25.0– 29.9 kg/m2 and 10.2% were ≥ 30.0 kg/m2. Compared with patients with the lowest BMI levels, those with BMI≥ 30 kg/m2 showed a younger, higher inflammatory response and a larger left atrium and were more likely to be combined with traditional cardiovascular risk factors. After adjustment for confounding variables, compared to BMI ≥ 30 kg/m2 group, patients with lower BMI (< 23 kg/m2) significantly increased the risk of NOAF in AMI patients (HR 2.884, 95% CI 1.302– 6.392). Moreover, the all-cause mortality and cardiac mortality in BMI < 23.0kg/m2 group was apparently higher than that in BMI≥ 30 kg/m2 group after a long-term follow-up.Conclusion: In this AMI cohort study, the present finding of an inverse association between BMI and risk of NOAF supports the “obesity paradox”. Decreasing BMI was associated with an increased risk of NOAF.Trial Registration: Prospective registered.Keywords: atrial fibrillation, acute myocardial infarction, body mass index, obesity

Abstract Background Spontaneous coronary artery dissection (SCAD) is now recognized as an important cause of acute coronary syndrome (ACS), which is thought to be more prevalent in women. However, the male patients, on the other hand, cannot be easily ignored. Case presentation A 26-year-old male suffered from SCAD that occurred in the left main coronary artery (LMCA) and a secondary acute myocardial infraction (AMI). Coronary CT angiography and coronary angiography (CAG) revealed aneurysms in the LMCA and right coronary artery (RCA), as well as a total occlusion in the proximal branch of the left anterior descending artery (LAD). Along with drug therapy, coronary artery bypass graft (CABG) surgery was recommended, and the patient has been symptom-free for one year. Conclusion We report a case of spontaneous left main coronary artery dissection that occurred in a young male. The necessity of identifying typical imaging features and following up patients with SCAD for life to reduce the risk of fatal cardiac complications cannot be overstated.

Intranasal (IN) administration has emerged as a novel approach for rapid systemic absorption, with potential applicability in the management of acute cardiovascular events. This review explores the evolution of IN cardiovascular pharmacotherapy, emphasizing its potential in achieving systemic effects and bypassing the first-pass metabolism associated with oral administration. The extensive vascularization of nasal mucosa and a porous endothelial basement membrane facilitate efficient drug absorption into the bloodstream. The IN route ensures a critical swift onset of action, which allows self-administration in at-home settings. For instance, etripamil nasal spray, a first-in-class formulation, exemplifies the therapeutic potential of this approach in the treatment of spontaneous supraventricular tachycardia. The review critically assesses studies on IN formulations for angina, acute myocardial infarction, hypertensive episodes, and cardiac arrhythmias. Preclinical evaluations of beta-blockers, calcium-channel blockers, and antianginal drugs demonstrate the feasibility of IN administration for acute cardiovascular events. A small number of clinical trials have revealed promising results, emphasizing the superiority of IN drug delivery over oral administration in terms of bioavailability and onset of action. Unambiguously, the limited clinical trials and patient enrollment pose challenges in generalizing experimental outcomes. However, the nose-to-heart approach has clinical potential.

Copyright of Health Bulletin / Zdravstveni Glasnik is the property of Faculty of Health Studies, University of Mostar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To investigate the correlation of serum levels of bridging integrating factor 1 (BIN1) with acute myocardial infarction (AMI) and Killip class of the patients., Methods: We retrospectively collected the data from 94 patients with AMI and 30 healthy individuals for analysis of the correlations of serum BIN1 levels with Killip class, TIMI scores, and neutrophil-to-lymphocyte ratio (NLR). We also assessed the diagnostic value of BIN1 combined with NLR for AMI., Results: Serum BIN1 levels were significantly lower in AMI patients than in the healthy individuals ( P =0.032). The AMI patients with Killip class I had significantly lower serum BIN1 levels than the healthy individuals ( P =0.008). Serum BIN1 level was an independent predictor of AMI with a predictive value of 0.630 (95% CI : 0.513-0.748) at the optimal cutoff level of 0.341 ng/mL, a specificity of 50%, and a sensitivity of 78.5%. Serum BIN1 level was also an independent predictor for Killip class I group in the AMI patients with a predictive value of 0.672 (95% CI : 0.548-0.797) at the optimal cutoff level of 0.287 ng/mL, a specificity of 74.1%, and a sensitivity of 60%. For AMI diagnosis, the combination of NLR and serum BIN1 level had a predictive value of 0.811 (95% CI : 0.727-0.895) at the optimal cutoff level of 0.548 ng/mL, with a specificity of 92.6% and a sensitivity of 62.2%. There was a positive correlation between serum BIN1 level and TIMI score in AMI patients ( r =0.186, P =0.003)., Conclusions: BIN1 is correlated with AMI and can be helpful for predicting short-term prognosis of the patients, and BIN1 combined with NLR has a high diagnostic value for AMI.

Acute myocardial infraction is the most severe type of coronary artery disease and remains a substantial burden to the health care system globally. Although myocardial reperfusion is critical for ischemic cardiac tissue survival, the reperfusion itself could cause paradoxical injury. This paradoxical phenomenon is known as ischemia-reperfusion injury (IRI), and the exact molecular mechanism of IRI is still far from being elucidated and is a topic of controversy. Meanwhile, ferroptosis is a nonapoptotic form of cell death that has been reported to be associated with various cardiovascular diseases. Thus, we explored the potential ferroptosis mechanism and target in cardiac IRI via bioinformatics analysis and experiment. GSE4105 data were obtained from the GEO database and consist of a rat IRI model and control. After identifying differentially expressed ferroptosis-related genes (DEFRGs) and hub genes of cardiac IRI, we performed enrichment analysis, coexpression analysis, drug-gene interaction prediction, and mRNA-miRNA regulatory network construction. Moreover, we validated and explored the multitemporal expression of hub genes in a hypoxia/reoxygenation (H/R)-induced H9C2 cell injury model under different conditions via RT-qPCR. A total of 43 DEFRGs and 7 hub genes (tumor protein p53 [Tp53], tumor necrosis factor [Tnf], hypoxia-inducible factor 1 subunit alpha [Hif1a], interleukin 6 [Il6], heme oxygenase 1 [Hmox1], X-box binding protein 1 [Xbp1], and caspase 8 [Casp8]) were screened based on bioinformatics analysis. The functional annotation of these genes revealed apoptosis, and the related signaling pathways could have association with the pathogenesis of ferroptosis in cardiac IRI. In addition, the expression of the seven hub genes in IRI models were found higher than that of control under different H/R conditions and time points. In conclusion, the analysis of 43 DEFRGs and 7 hub genes could reveal the potential biological pathway and mechanism of ferroptosis in cardiac IRI. In addition, the multitemporal expression change of hub genes in H9C2 cells under different H/R conditions could provide clues for further ferroptosis mechanism exploring, and the seven hub genes could be potential biomarkers or therapeutic targets in cardiac IRI. [ABSTRACT FROM AUTHOR]

Developing sensitive and reliable strategies for the simultaneous detection of multiple miRNAs is crucial for the accurate diagnosis of acute myocardial infraction (AMI). Herein, we have rationally designed a signal amplifier-assisted DNA "AND" logic gate for simultaneously detecting three AMI-related miRNAs. To achieve amplified signal output, hairpins labeled with FAM and BHQ1 are employed, which remain in the signal-off state. Upon the input of all three targets, the "AND" logic gate is activated, resulting in the release of a trigger molecule. This trigger molecule then initiates the catalytic hairpin assembly (CHA) reaction, leading to amplified fluorescence signal enhancement. Notably, the system demonstrates excellent sensing performance in serum, exhibiting a wide detection range spanning from 0.05 to 20 nM and low limits of detection (31.34, 39.07, and 23.86 pM) for the three miRNAs. The AND-CHA system ensures that fluorescence signal output is obtained only when all three inputs are present simultaneously. It provides a direct result without the need for further signal analysis, thereby improving diagnostic accuracy and convenience. • Developing a "AND" logical biosensor equipped with a signal amplifier. • Obtaining amplified single output straightforwardly upon receiving three inputs. • Achieving simultaneous detection of three AMI-related miRNAs in serum samples. • Providing a sensitive, accurate, and convenient method for the diagnosis of AMI. [ABSTRACT FROM AUTHOR]

Background: Spontaneous coronary artery dissection (SCAD) is now recognized as an important cause of acute coronary syndrome (ACS), which is thought to be more prevalent in women. However, the male patients, on the other hand, cannot be easily ignored.Case Presentation: A 26-year-old male suffered from SCAD that occurred in the left main coronary artery (LMCA) and a secondary acute myocardial infraction (AMI). Coronary CT angiography and coronary angiography (CAG) revealed aneurysms in the LMCA and right coronary artery (RCA), as well as a total occlusion in the proximal branch of the left anterior descending artery (LAD). Along with drug therapy, coronary artery bypass graft (CABG) surgery was recommended, and the patient has been symptom-free for one year.Conclusion: We report a case of spontaneous left main coronary artery dissection that occurred in a young male. The necessity of identifying typical imaging features and following up patients with SCAD for life to reduce the risk of fatal cardiac complications cannot be overstated. [ABSTRACT FROM AUTHOR]

Long-term exposure to air pollution results in a high incidence of cardiovascular disease. Many studies have found that short-term exposure to air pollution can trigger acute myocardial infarction. This study aims to determine whether results in areas with different levels of severity of air pollution are similar. The study design is a time-stratified case-crossover analysis. This was a retrospective study based on hospital medical records. The study period was since 1 January 2017 to 31 December 2018. Research data were collected from Taoyuan Hospital, located in an area with low severity of pollution, and Taichung Hospital, located in an area with high severity of pollution. The correlation between short-term air pollution exposure and acute myocardial infarction was analyzed. The correlation between short-term exposure to ambient air pollutants and acute myocardial infarction was not significant for the cases collected from Taoyuan Hospital (PM2.5 OR: 1.006 and 95% CI: 0.995–1.017; PM10 OR: 0.996 and 95% CI: 0.988–1.003). However, for the cases collected from Taichung Hospital, short-term exposure to ambient PM2.5 (odds ratio: 1.021; 95% confidence interval: 1.002–1.040) and PM10 (odds ratio: 1.010; 95% confidence interval: 1.001–1.020) resulted in high incidence of acute myocardial infarction. Short-term pollutant exposure will increase the incidence of acute myocardial infarction based on the severity of regional air pollution. In addition to addressing traditional cardiovascular disease risk factors, the government must formulate relevant policies for reducing air pollution and the resulting hazards to citizens' health. [ABSTRACT FROM AUTHOR]

Copyright of Kufa Journal for Nursing Sciences is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The mechanisms and clinical impact of acute kidney injury (AKI) after acute myocardial infarction (AMI) may differ depending on whether AKI develops during the early or late phase after AMI. The present study assessed the timing of AKI onset and the prognostic impact on long-term outcomes in patients hospitalized with AMI. Methods: The present study enrolled consecutive AMI survivors who had undergone successful percutaneous coronary interventions at admission. AKI was defined as an increase in the serum creatinine level of ≥0.3 mg/dL above the admission value within 7 days of hospitalization. AKI patients were further divided into two subgroups (early-phase AKI: within 3 days vs. late-phase AKI: 4 to 7 days after AMI onset). The primary endpoint was all-cause death. Results: In total, 506 patients were included in this study, with 385 men and a mean age of 69.5 ± 13.5 years old. The mean follow-up duration was 1289.5 ± 902.8 days. AKI developed in 127 patients (25.1%). Long-term mortality was significantly higher in the AKI group than in the non-AKI group (log-rank p

Background: Intervention planning to reduce 30-day readmission post-acute myocardial infarction (AMI) in an environment of resource scarcity can be improved by readmission prediction score. The aim of study is to derive and validate a prediction model based on routinely collected hospital data for identification of risk factors for all-cause readmission within zero to 30 days post discharge from AMI. Methods: Our study includes 2,849 AMI patient records (January 2005 to December 2014) from a tertiary care facility in India. EMR with ICD-10 diagnosis, admission, pathological, procedural and medication data is used for model building. Model performance is analyzed for different combination of feature groups and diabetes sub-cohort. The derived models are evaluated to identify risk factors for readmissions. Results: The derived model using all features has the highest discrimination in predicting readmission, with AUC as 0.62; (95 percent confidence interval ) in internal validation with 70/30 split for derivation and validation. For the sub-cohort of diabetes patients (1359) the discrimination is slightly better with AUC 0.66; (95 percent CI; ). Some of the positively associated predictive variables, include age group 80-90, medicine class administered during index admission (Anti-ischemic drugs, Alpha 1 blocker, Xanthine oxidase inhibitors), additional procedure in index admission (Dialysis). While some of the negatively associated predictive variables, include patient demography (Male gender), medicine class administered during index admission (Betablocker, Anticoagulant, Platelet inhibitors, Anti-arrhythmic). Conclusions: Routinely collected data in the hospital's clinical and administrative data repository can identify patients at high risk of readmission following AMI, potentially improving AMI readmission rate. [ABSTRACT FROM AUTHOR]

Introduction: Ischemic heart disease is frequent, has different manifestation forms, and predominates among diseases leading to patient admission into emergency units and hospital admissions in general.Objective: To deepen the knowledge of patients with ischemic heart disease in a municipal intensive care unit.Method: A descriptive and cross-sectional study was carried out of 528 patients who were admitted into the intensive care unit of Orlando Pantoja Tamayo General Teaching Hospital in Contramaestre Municipality, Santiago de Cuba, with a diagnosis of ischemic heart disease, from January 2016 to June of 2019. The variables used were age group, sex, diagnosis at admission, personal pathological history, hospital stay, and status at discharge. We used percentage to summarize the information, as well as the chi-square test to identify statistical association.Results: There was a predominance of males and ages between 60-70 and 36-59 years. Acute myocardial infarction and the combination of three or more risk factors were more frequent. The highest number of deaths occurred in the first three days after admission and among patients with invasive mechanical ventilation.Conclusions: The characteristics of cardiovascular diseases continues to be a major health concern, as long as they are appearing at increasingly earlier ages. In severe cases, mortality can occur in the first seventy-two hours.

Despite extensive clinical research and management protocols applied in the field of coronary artery diseases (CAD), it still holds the number 1 position in mortality worldwide. This indicates that we need to work on precision medicine to discover the diagnostic, therapeutic, and prognostic targets to improve the outcome of CAD. In precision medicine, epigenetic changes play a vital role in disease onset and progression. Epigenetics is the study of heritable changes that do not affect the alterations of DNA sequence in the genome. It comprises various covalent modifications that occur in DNA or histone proteins affecting the spatial arrangement of the DNA and histones. These multiple modifications include DNA/histone methylation, acetylation, phosphorylation, and SUMOylation. Besides these covalent modifications, non-coding RNAs—viz. miRNA, lncRNA, and circRNA are also involved in epigenetics. Smoking, alcohol, diet, environmental pollutants, obesity, and lifestyle are some of the prime factors affecting epigenetic alterations. Novel molecular techniques such as next-generation sequencing, chromatin immunoprecipitation, and mass spectrometry have been developed to identify important cross points in the epigenetic web in relation to various diseases. The studies regarding exploration of epigenetics, have led researchers to identify multiple diagnostic markers and therapeutic targets that are being used in different disease diagnosis and management. Here in this review, we will discuss various ground-breaking contributions of past and recent studies in the epigenetic field in concert with coronary artery diseases. Future prospects of epigenetics and its implication in CAD personalized medicine will also be discussed in brief. [ABSTRACT FROM AUTHOR]

Abstract—An immunochromatographic test system for the combined analysis of two cardiomarkers, such as fatty acid binding protein (FABP) and troponin I (TnI), in serum and whole blood is developed. The main stages of the design of a multiparametric system are investigated, including the influence of the antibody position and gold nanoparticle size on the results. The detection limits of the method are found to be 10 ng/mL for FABP and 1 ng/mL for TnI, and the coefficient of variation did not exceed 10%. The developed test system allows us to confirm the diagnosis of acute myocardial infraction (N = 9). The analysis time is 15 min. [ABSTRACT FROM AUTHOR]

BACKGROUND: Coronary artery spasm (CAS) can result in life-threatening arrhythmia and sudden cardiac death. Although this disorder has been known for a long time, little is known about it, and its mechanisms have been not identified yet.CASE REPORT: We describe a 52-year-old woman with no significant cardiovascular risk factors who experienced several episodes of spontaneous and coincident multivessel coronary artery spasm, which led to myocardial infarction as well as malignant arrhythmias. Coronary angiography revealed severe migratory narrowing in the left anterior descending artery and right coronary artery.CONCLUSION: Simultaneous multivessel coronary artery spasm develop multisite myocardial infarction (MI), and malignant arrhythmias could occur even in the absence of significant stenosis and triggering factors, which would lead to an increased risk of life-threatening cardiac events.

There are various studies that have addressed the use of Cyclosporine among patients with acute myocardial infarction (AMI). However, to date there is hardly any concise and systematically structured evidence that debate on the efficacy and safety of Cyclosporine in AMI patients. The aim of this review is to systematically summarize the overall evidence from published trials, and to conduct a meta-analysis in order to determine the efficacy and safety of Cyclosporine vs. placebo or control among patients with AMI. All randomized control trial (RCT) published in English language from January 2000 to August 2017 were included for the systematic review and meta-analysis. A total of six RCTs met the inclusion and were hence included in the systematic review and meta-analysis. Based on the performed meta-analysis, no significant difference was found between Cyclosporine and placebo in terms of left ventricular ejection fraction (LVEF) improvement (mean difference 1.88; 95% CI −0.99 to 4.74; P = 0.2), mortality rate (OR 1.01; 95% Cl 0.60 to 1.67, P = 0.98) and recurrent MI occurrence (OR 0.65; 95% Cl 0.29 to 1.45, P = 0.29), with no evidence of heterogeneity, when given to patients with AMI. Cyclosporine also did not significantly lessen the rate of rehospitalisation in AMI patients when compared to placebo (OR 0.91; 95% Cl 0.58 to 1.42, P = 0.68), with moderate heterogeneity (I2 = 46%). There was also no significant improvement in heart failure events between Cyclosporine and placebo in AMI patients (OR 0.63; 95% Cl 0.31 to 1.29, P = 0.21; I2 = 80%). No serious adverse events were reported in Cyclosporine group across all studies suggesting that Cyclosporine is well tolerated when given to patients with AMI. The use of Cyclosporine in this group of patients, however, did not result in better clinical outcomes vs. placebo at improving LVEF, mortality rate, recurrent MI, rehospitalisation and heart failure event.

Introduction: Acute myocardial infarction (AMI), commonly referred to as a heart attack, is a leading global cause of mortality, necessitating immediate recognition and appropriate actions. This study aims to assess AMI awareness and response among the general population in Alahssa, Saudi Arabia., Methodology: A descriptive cross-sectional design was employed, with surveys distributed via online platforms. Participants aged 18 years and older, residing in Alahssa, and providing informed consent were included., Results: Among 406 participants, 74.1% had good knowledge levels. Notably, 216 (53.2%) recognized calling an ambulance as the initial response to AMI symptoms. The Internet (140, 28.9%) and healthcare professionals (113, 23.3%) were primary information sources, with "sudden pain or discomfort in arms or hands" (287, 27.8%) as the most recognized symptom. "Obesity" and "heart disease" (304, 12.3%) were the most common risk factors. Demographic variations in knowledge were observed., Conclusion: This study highlights the need to enhance public awareness of AMI, particularly among specific demographic groups. Targeted educational campaigns can improve knowledge, promote appropriate actions, and ultimately enhance outcomes during AMI events in Alahssa, Saudi Arabia., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Research Ethics Committee of King Faisal University issued approval KFU-REC-2022-SEP–ETHICS1,329. Having reviewed the details submitted by the applicant regarding the abovenamed research project, the Research Ethics Committee at King Faisal University grants its ethical approval to the protocol. Projects may be subject to an audit or any other form of monitoring by the committee at any time. The committee may request a regular report on the progress of the project to ensure that researchers are committed to the highest ethical standards. Researchers are held accountable for the storage, retention, and security of original data obtained from projects. Any substantial alterations to the project or emerging events or matters that may affect the ethical acceptability of the project must be reported immediately to the committee via email (ialjreesh@kfu.edu.sa) or phone (0096615899773). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2023, Almaqhawi et al.)

There are various studies that have addressed the use of Cyclosporine among patients with acute myocardial infarction (AMI). However, to date there is hardly any concise and systematically structured evidence that debate on the efficacy and safety of Cyclosporine in AMI patients. The aim of this review is to systematically summarize the overall evidence from published trials, and to conduct a meta-analysis in order to determine the efficacy and safety of Cyclosporine vs. placebo or control among patients with AMI. All randomized control trial (RCT) published in English language from January 2000 to August 2017 were included for the systematic review and meta-analysis. A total of six RCTs met the inclusion and were hence included in the systematic review and meta-analysis. Based on the performed meta-analysis, no significant difference was found between Cyclosporine and placebo in terms of left ventricular ejection fraction (LVEF) improvement (mean difference 1.88; 95% CI −0.99 to 4.74; P = 0.2), mortality rate (OR 1.01; 95% Cl 0.60 to 1.67, P = 0.98) and recurrent MI occurrence (OR 0.65; 95% Cl 0.29 to 1.45, P = 0.29), with no evidence of heterogeneity, when given to patients with AMI. Cyclosporine also did not significantly lessen the rate of rehospitalisation in AMI patients when compared to placebo (OR 0.91; 95% Cl 0.58 to 1.42, P = 0.68), with moderate heterogeneity (I2 = 46%). There was also no significant improvement in heart failure events between Cyclosporine and placebo in AMI patients (OR 0.63; 95% Cl 0.31 to 1.29, P = 0.21; I2 = 80%). No serious adverse events were reported in Cyclosporine group across all studies suggesting that Cyclosporine is well tolerated when given to patients with AMI. The use of Cyclosporine in this group of patients, however, did not result in better clinical outcomes vs. placebo at improving LVEF, mortality rate, recurrent MI, rehospitalisation and heart failure event. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the relationship between the expression levels of microRNA-208b and early diagnosis of the acute myocardial infarction. MATERIALS AND METHODS: Literature search were performed within PubMed, Medline, Embase, and CNKI databases, according to inclusion and exclusion criteria, and other relevant literatures about included studies were searched to get more information about this study. Two staff members extracted data from the included studies for meta-analysis. RESULTS: This study included 6 documents, involving a total of 826 patients with acute myocardial infarction and 429 controls. Meta-analysis results: sensitivity 82%, specificity 83%, positive likelihood ratio of 5.0, negative likelihood ratio 0.21, diagnostic odds ratio area was 23, area under operating characteristic curve was 0.88 (95% CI: 0.85-0.91). CONCLUSIONS: microRNA-208b expression was increased in the blood of patients with acute myocardial infarction, and may be used for the early diagnosis of acute myocardial infarction molecular biomarkers. [ABSTRACT FROM AUTHOR]

Aim: In acute myocardial fraction (AMI) patients, the association between lipid parameters and new-onset atrial fibrillation (NOAF) remains unclear due to limited evidence., Methods: A total of 4282 participants free from atrial fibrillation (AF) at baseline were identified in Beijing Friendship Hospital. Fasting levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured at baseline. The study population was stratified based on tertiles of lipid profile and lipid ratios. Incidence of NOAF was observed at the follow-up visits. The associations between different lipid parameters and the incidence of NOAF were assessed by multivariate Cox regression analysis., Results: Over a median follow-up period of 42.0 months (IQR: 18.7, 67.3 months), 3.1% (N=132) AMI patients developed NOAF. After multivariable adjustment, higher TC (hazard ratios (HR): 0.205, 95% confidence intervals (CI): 0.061-0.696) levels were inversely associated with NOAF development. However, higher HDL-C (HR: 1.892, 95% CI: 1.133-3.159) levels were positively associated with NOAF development. LDL-C levels, TG levels, non-HDL-C levels, and lipid ratios showed no association with NOAF development., Conclusion: TC levels were inversely associated with incidence of NOAF; this was mainly reflected in the subgroups of male gender and older patients (65 years or older). HDL-C levels were positively associated with incidence of NOAF; this was mainly reflected in the subgroups of male gender and younger patients (age ＜65 years). There was no significant association of NOAF with LDL-C, TG, or non-HDL-C levels.

Introduction: Cardiovascular disease has become one of the most common diseases in the world with the development of the industrial society. This study was conducted to examine the complications of thrombolytic treatment and their effects on nursing practices. Methods: This descriptive and observational research was carried out on 60 patients who were hospitalized with acute myocardial infraction in the coronary intensive care units of a public hospital between January, 2011 and December, 2011. In collection of the data the questionnaire developed by the researchers was used. In evaluation of the data frequency and percentage values were used in SPSS 17.0 software. Results: It was determined that the 73,3% of patients participated in the study were male, 56,7% were in between 50-69 age group; 55% were smoking and 33% had alcohol consumption habit. According to the ST localization; 60% of patients were diagnosed with inferior myocardial infraction and 70% had hypertension, the developed complications were determined in 96,7% of patients as 97% minor bleeding, 95% arrhythmia, 93,3% hypotension, 3,3% fever and 1,7 major bleeding. It was found that the 93,3% of minor bleeding complications were in intravenous failed attempt places, 16,7% gingiva, 3,3% intraocular bleeding, 15% epistaxis, 5% ecchymosis. Conclusion: Nurses were advised to follow the patients in terms of complications and to open vascular accesses more carefully on patients who will get treatment of acute myocardial infraction. [ABSTRACT FROM AUTHOR]

Aim: A prospective of Troponin T as a diagnostic marker in the detection of acute myocardial infarction at autopsy. Materials and method: The internal autopsy was done for 50 sudden death bodies and 5 deaths consisting of deaths due to poisoning, stroke, tuberculosis etc. Adult dead body with cause of death unexplained by external examination were studied and autopsy was done within 48 hours of death. Results: AMI was established as a cause of death in 19 of the 50 cases (36.7%) and confirmed on histological examination. Of the 19 cases of AMI, 17 (92%) showed an elevated Troponin T level [> 0.03mg/L]. There were 31 cases where the Troponin T levels were elevated but the cause of death was due to alternate causes other than an AMI. This yielded a sensitivity of 92% and a specificity of 5% (p=0.62; chi-squared test) for Troponin T in predicting an AMI at autopsy. Correspondingly, the positive and negative predictive value of Troponin T was 36% and 57% respectively. Conclusion: In clinical practice, Troponin T has been extensively investigated and found to be a sensitive marker of myocardial infarction. While our study confirms that Troponin T is sensitive at detecting AMI, it is unfortunately not specific to this disease process. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine the frequency of Acute Myocardial Infarction in patients with Diabetes Mellitus, and short term survival in these patients. METHODOLOGY: This study included 100 patients, was carried out in department of Cardiology, Liaquat University Hospital Hyderabad. Diagnosed cases of type 2 Diabetes Mellitus (DM) requiring Hospitalization with ST elevation, myocardial Infarction and meeting the criteria were enrolled in the study. The final diagnosis of Acute Myocardial Infarction was made within 48 hours of admission. The blood glucose level and glycosylated haemoglobin (HbA1c) were checked to evaluate the glycemic status. The short term survival was evaluated by recording inhospital mortality and mortality during follow-up period of 30 days; by contacting at their residential address or contact number. RESULTS: In the present study total 100 consecutive diabetic cases with acute Myocardial infarction were selected. The males patients outnumbered females. On the ECG and echocardiogram findings 39% patients had anterior wall MI. All male (n=65)patients had short term mortality of 27.68%, stratification showed that 6.15% was between 1-10 days, 9.23% between 11-20 days and 12.30% mortality was found between 21-30 days. The corresponding figures in female (n=35) patients was 25.33%, stratification showed 8.57% mortality between 1-10 days, 5.71% seen between 11-20 days and in the 11.4% mortality was noted between 21-30 days. CONCLUSION: The short term mortality after acute myocardial infarction in diabetic patients is significantly high, both male and female suffer almost equally. [ABSTRACT FROM AUTHOR]

Emerging evidence uncovers the important involvement of circular RNAs (circRNAs) in the dysfunction of cardiomyocytes under hypoxia conditions. However, no studies proved whether circTRRAP (hsa&#95;circ&#95;0081241) can participate in cardiomyocyte injury evoked by hypoxia.A qRT-PCR or immunoblotting method was used to evaluate the expression of circTRRAP, miR-761, and mitogen-activated protein kinase kinase kinase 2 (MAP3K2). The direct relationships of circTRRAP/miR-761 and miR-761/MAP3K2 were confirmed by RNA immunoprecipitation (RIP) assay, dual-luciferase reporter assay, and RNA pull-down assay. The effects of the circTRRAP/miR-761/MAP3K2 axis on cell functional behaviors were examined by 5-ethynyl-2'-deoxyuridine (EdU) assay, CCK-8 assay, and flow cytometry. The production levels of proinflammatory cytokines (IL-1β, TNF-α, and IL-6) were evaluated by enzyme-linked immunosorbent assay.CircTRRAP and MAP3K2 were overexpressed but miR-761 was downregulated in AC16 cardiomyocytes under hypoxia and in the serum of patients with acute myocardial infarction. Silencing circTRRAP attenuated hypoxia-evoked inflammation, apoptosis, and oxidative stress in human AC16 cardiomyocytes. CircTRRAP targeted miR-761, and miR-761 directly targeted and suppressed MAP3K2. CircTRRAP involved the post-transcriptional regulation of MAP3K2 through miR-761, indicating its competing endogenous RNA (ceRNA) activity. Moreover, miR-761 inhibition abolished the effects of circTRRAP depletion in hypoxia-induced cell injury. MAP3K2 silencing phenocopied miR-761 increase in attenuating hypoxia-evoked cardiomyocyte inflammation, apoptosis, and oxidative stress.Our study demonstrates that circTRRAP can protect AC16 cardiomyocytes from hypoxia-evoked injury through the miR-761/MAP3K2 axis.

Objectives: Extracellular matrix (ECM) remodelling is a critical aspect of cardiac remodelling following myocardial infarction. Tissue inhibitors of metalloproteinases (TIMPs) are physiological inhibitors of matrix metalloproteinases (MMPs) that degrade the ECM proteins. TIMP-3 is highly expressed in the heart and is markedly downregulated in patients with ischaemic cardiomyopathy. Cell-based gene therapy can enhance the effects of cell transplantation by temporally and spatially regulating the release of the gene product. The purpose of this study was to investigate the role of TlMP-3 gene-transfected vascular smooth muscle cells (VSMCs) in modifying heart structure and function in rats when transplanted 3 days after myocardial infarction (MI). Methods: Anesthetised rats were subjected to coronary artery ligation followed 3 days later by thoracotomy and transplantation of TlMP-3 gene-transfected VSMCs, untransfected VSMCs or medium injected directly into the Ischaemic myocardium. We assessed left ventricular structure and function by echocardiography and morphometiy, and measured the levels of myocardial matrix metalloproteinase-2 and -9 (MMP-2, MMP-9), TIMP-3 and tumour necrosis factor-α (TNE-α) at 4 weeks post-myocardial infarction. Results: Transplantation of TlMP-3 gene-transfected VSMCs and untransfected VSMCs significantly decreased scar expansion and ventricular dilatation 25 days post-transplantation (4 weeks after MI). MMPs and TNF-α levels were reduced in the transplantation groups when compared to the group that was given an injection of medium only. Transplantation of TIMP-3 gene-transfected VSMCs was more effective in preventing progressive cardiac dysfunction, ventricular dilatation and in reducing MMP-2, MMP-9 and TNF-α levels when compared to the transplantation of untransfected VSMCs. ConclusioTK: TIMP-3 gene transfection was associated with attenuated left ventricular dilation and recovery of systolic function after MI compared with the control. TlMP-3 transfection enhanced the effects of transplanted VSMCs in rats by inhibiting matrix degradation and inflammatory cytokine expression, leading to improved myocardial remodelling. [ABSTRACT FROM AUTHOR]

Acute myocardial infraction is the most severe type of coronary artery disease and remains a substantial burden to the health care system globally. Although myocardial reperfusion is critical for ischemic cardiac tissue survival, the reperfusion itself could cause paradoxical injury. This paradoxical phenomenon is known as ischemia-reperfusion injury (IRI), and the exact molecular mechanism of IRI is still far from being elucidated and is a topic of controversy. Meanwhile, ferroptosis is a nonapoptotic form of cell death that has been reported to be associated with various cardiovascular diseases. Thus, we explored the potential ferroptosis mechanism and target in cardiac IRI via bioinformatics analysis and experiment. GSE4105 data were obtained from the GEO database and consist of a rat IRI model and control. After identifying differentially expressed ferroptosis-related genes (DEFRGs) and hub genes of cardiac IRI, we performed enrichment analysis, coexpression analysis, drug-gene interaction prediction, and mRNA-miRNA regulatory network construction. Moreover, we validated and explored the multitemporal expression of hub genes in a hypoxia/reoxygenation (H/R)-induced H9C2 cell injury model under different conditions via RT-qPCR. A total of 43 DEFRGs and 7 hub genes (tumor protein p53 [Tp53], tumor necrosis factor [Tnf], hypoxia-inducible factor 1 subunit alpha [Hif1a], interleukin 6 [Il6], heme oxygenase 1 [Hmox1], X-box binding protein 1 [Xbp1], and caspase 8 [Casp8]) were screened based on bioinformatics analysis. The functional annotation of these genes revealed apoptosis, and the related signaling pathways could have association with the pathogenesis of ferroptosis in cardiac IRI. In addition, the expression of the seven hub genes in IRI models were found higher than that of control under different H/R conditions and time points. In conclusion, the analysis of 43 DEFRGs and 7 hub genes could reveal the potential biological pathway and mechanism of ferroptosis in cardiac IRI. In addition, the multitemporal expression change of hub genes in H9C2 cells under different H/R conditions could provide clues for further ferroptosis mechanism exploring, and the seven hub genes could be potential biomarkers or therapeutic targets in cardiac IRI., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wang, He, Xuan, Zhang, Xu, Lin, Li, Chen and Jiang.)

Abstract: Background: Anemia is associated with an unfavorable outcome in acute myocardial infarction (AMI). An acute phase response could contribute to the development of anemia in AMI patients. Methods: We have performed a cross-sectional analysis on prospectively collected data at a tertiary hospital catheterization laboratory. Multi-adjusted linear regression models were fitted for hemoglobin as the dependent variable. ANOVA tests were used to determine interactions between time cutoffs of the respective hemoglobin and the concentrations of two inflammatory proteins, namely C-reactive protein and fibrinogen. Anemia indices were analyzed in a subgroup of 138 male AMI patients for whom frozen serum samples were available. Results: Enrolled were 1017 patients (340 with unstable angina pectoris [UAP] and 677 with AMI). Correlates of hemoglobin in the AMI group included age, male gender, the inflammatory proteins, as well as time from symptom onset to angiography (r 2 =0.47; p <0.001). A significant decrease in the concentration of hemoglobin with a parallel increase in the inflammatory proteins was observed between the time cutoff from symptom onset to angiography only in the AMI group for males and females, respectively. A pattern suggestive of anemia of inflammation including higher ferritin, lower transferring, lower transferrin saturation, and lower serum iron concentrations has been observed in anemic AMI patients ( all p <0.05). Conclusions: Inflammation-sensitive proteins are associated with lower hemoglobin concentrations in AMI patients. We therefore suggest the possibility that at least part of the hemoglobin drop in AMI prior to angiography is related to the anemia of inflammation. [Copyright &y& Elsevier]

The aim of this study is to evaluate the differences of left ventricular (LV) twist and untwisting rate in patients with acute myocardial infarction (AMI) as compared with healthy subjects by means of Speckle Tracking Imaging (STI). 45 AMI patients (AMI group) and 48 healthy subjects (NOR group) were studied. Two-dimensional STI was performed in all patients. Peak apical rotation, peak basal rotation, peak LV twist, peak basal untwisting rate, peak apical untwisting rate, peak LV untwisting rate, time to peak LV twist, and untwisting rate were measured. In comparison with the NOR group, peak LV rotational parameters were found to be decreased in the AMI group ( P < 0.01). A strong correlation was found between the peak LV twist and LV ejection fraction in the overall study population ( P < 0.001). The LV twist is strongly related to LV systolic function, and the impairment of LV function observed in patients with AMI is associated with a decrease of LV twist and untwist rate. The STI appears to accurately evaluate LV function. [ABSTRACT FROM AUTHOR]