Thrombomodulin can predict the incidence of second events in patients with acute coronary syndrome: Single-center, retrospective cohort study
•In ACS patients after PCI, EF, elevated BNP and HbA1c were associated with MACEs by any cause.•Thrombomodulin (TM) levels were significantly associated with MACEs in multivariate analysis.•The association between TM and MACEs was especially high and unaffected by the stage of cardiac or renal funct...
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| Veröffentlicht in: | Journal of cardiology 2018-12, Vol.72 (6), p.494-500 |
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| creator | Kosaki, Ryota Minoura, Yoshino Ogura, Kunihiro Oishi, Yosuke Tanaka, Lisa Arai, Ken Nomura, Kosuke Sakai, Koshiro Sekimoto, Teruo Nisikura, Tenjin Tsujita, Hiroaki Kondo, Seita Tsukamoto, Shigeto Hamazaki, Yuji Kobayashi, Youichi |
| description | •In ACS patients after PCI, EF, elevated BNP and HbA1c were associated with MACEs by any cause.•Thrombomodulin (TM) levels were significantly associated with MACEs in multivariate analysis.•The association between TM and MACEs was especially high and unaffected by the stage of cardiac or renal function.
Plasma levels of atherothrombosis-related markers such as endothelial biomarkers have been reported to predict the risk of first acute coronary syndrome (ACS) events. Percutaneous coronary intervention (PCI) by balloon angioplasty and stenting established as a treatment for ACS enabled early discharge and early clinic care. The procedure of PCI, however, may itself be associated with arterial injury with endothelial dysfunction. The clinical significance of those biomarkers for second events in patients after PCI has not yet been completely understood to identify patients who need strict follow-up.
After the exclusion of 100 patients (60 deaths during hospitalization, 40 severe renal failure), 400 ACS patients (291 males, 71.1±13.0 years) who had undergone successful PCI followed by biomarker assessment within the first postoperative hour were enrolled. We evaluated atherothrombosis-related biomarkers: thrombomodulin (TM), C-reactive protein (CRP), and D-dimer, prothrombin fragment F1+2, and plasminogen activator inhibitor-1, other than those assessed by routine biochemical tests. The outcome after PCI in ACS patients was assessed by the incidence of major adverse cardiovascular events (MACEs).
MACEs occurred in 112 patients during the follow-up period (813.9±474.8 days). As in previous reports, patients with MACEs showed decreased left ventricular ejection fraction (LVEF) by echocardiography, elevated brain natriuretic peptide and HbA1c than patients without MACEs. Not only these markers but also TM were significantly associated with MACEs in multivariate analysis. There were no significant correlations between MACEs and CRP. The association between TM and MACEs was especially high (odds ratio 2.73) and unaffected by the stage of cardiac (≤40, 40 |
| doi_str_mv | 10.1016/j.jjcc.2018.05.006 |
| format | Article |
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Plasma levels of atherothrombosis-related markers such as endothelial biomarkers have been reported to predict the risk of first acute coronary syndrome (ACS) events. Percutaneous coronary intervention (PCI) by balloon angioplasty and stenting established as a treatment for ACS enabled early discharge and early clinic care. The procedure of PCI, however, may itself be associated with arterial injury with endothelial dysfunction. The clinical significance of those biomarkers for second events in patients after PCI has not yet been completely understood to identify patients who need strict follow-up.
After the exclusion of 100 patients (60 deaths during hospitalization, 40 severe renal failure), 400 ACS patients (291 males, 71.1±13.0 years) who had undergone successful PCI followed by biomarker assessment within the first postoperative hour were enrolled. We evaluated atherothrombosis-related biomarkers: thrombomodulin (TM), C-reactive protein (CRP), and D-dimer, prothrombin fragment F1+2, and plasminogen activator inhibitor-1, other than those assessed by routine biochemical tests. The outcome after PCI in ACS patients was assessed by the incidence of major adverse cardiovascular events (MACEs).
MACEs occurred in 112 patients during the follow-up period (813.9±474.8 days). As in previous reports, patients with MACEs showed decreased left ventricular ejection fraction (LVEF) by echocardiography, elevated brain natriuretic peptide and HbA1c than patients without MACEs. Not only these markers but also TM were significantly associated with MACEs in multivariate analysis. There were no significant correlations between MACEs and CRP. The association between TM and MACEs was especially high (odds ratio 2.73) and unaffected by the stage of cardiac (≤40, 40<LVEF≤55, 55<%) or renal function (≤40, 40<creatinine clearance≤75, 75<ml/min).
TM is independently associated with MACEs and may be predictive of second events in patients after PCI for ACS. ACS patients with high TM value need strict follow up.</description><identifier>ISSN: 0914-5087</identifier><identifier>EISSN: 1876-4738</identifier><identifier>DOI: 10.1016/j.jjcc.2018.05.006</identifier><identifier>PMID: 29887328</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Acute coronary syndrome ; Endothelial dysfunction ; Second event ; Thrombomodulin</subject><ispartof>Journal of cardiology, 2018-12, Vol.72 (6), p.494-500</ispartof><rights>2018 Japanese College of Cardiology</rights><rights>Copyright © 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-c4f433a65ffaa3c661e96a8ee084020f95383831ec9997203e0f66413e95acf53</citedby><cites>FETCH-LOGICAL-c380t-c4f433a65ffaa3c661e96a8ee084020f95383831ec9997203e0f66413e95acf53</cites><orcidid>0000-0003-2595-2043</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0914508718301412$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29887328$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kosaki, Ryota</creatorcontrib><creatorcontrib>Minoura, Yoshino</creatorcontrib><creatorcontrib>Ogura, Kunihiro</creatorcontrib><creatorcontrib>Oishi, Yosuke</creatorcontrib><creatorcontrib>Tanaka, Lisa</creatorcontrib><creatorcontrib>Arai, Ken</creatorcontrib><creatorcontrib>Nomura, Kosuke</creatorcontrib><creatorcontrib>Sakai, Koshiro</creatorcontrib><creatorcontrib>Sekimoto, Teruo</creatorcontrib><creatorcontrib>Nisikura, Tenjin</creatorcontrib><creatorcontrib>Tsujita, Hiroaki</creatorcontrib><creatorcontrib>Kondo, Seita</creatorcontrib><creatorcontrib>Tsukamoto, Shigeto</creatorcontrib><creatorcontrib>Hamazaki, Yuji</creatorcontrib><creatorcontrib>Kobayashi, Youichi</creatorcontrib><title>Thrombomodulin can predict the incidence of second events in patients with acute coronary syndrome: Single-center, retrospective cohort study</title><title>Journal of cardiology</title><addtitle>J Cardiol</addtitle><description>•In ACS patients after PCI, EF, elevated BNP and HbA1c were associated with MACEs by any cause.•Thrombomodulin (TM) levels were significantly associated with MACEs in multivariate analysis.•The association between TM and MACEs was especially high and unaffected by the stage of cardiac or renal function.
Plasma levels of atherothrombosis-related markers such as endothelial biomarkers have been reported to predict the risk of first acute coronary syndrome (ACS) events. Percutaneous coronary intervention (PCI) by balloon angioplasty and stenting established as a treatment for ACS enabled early discharge and early clinic care. The procedure of PCI, however, may itself be associated with arterial injury with endothelial dysfunction. The clinical significance of those biomarkers for second events in patients after PCI has not yet been completely understood to identify patients who need strict follow-up.
After the exclusion of 100 patients (60 deaths during hospitalization, 40 severe renal failure), 400 ACS patients (291 males, 71.1±13.0 years) who had undergone successful PCI followed by biomarker assessment within the first postoperative hour were enrolled. We evaluated atherothrombosis-related biomarkers: thrombomodulin (TM), C-reactive protein (CRP), and D-dimer, prothrombin fragment F1+2, and plasminogen activator inhibitor-1, other than those assessed by routine biochemical tests. The outcome after PCI in ACS patients was assessed by the incidence of major adverse cardiovascular events (MACEs).
MACEs occurred in 112 patients during the follow-up period (813.9±474.8 days). As in previous reports, patients with MACEs showed decreased left ventricular ejection fraction (LVEF) by echocardiography, elevated brain natriuretic peptide and HbA1c than patients without MACEs. Not only these markers but also TM were significantly associated with MACEs in multivariate analysis. There were no significant correlations between MACEs and CRP. The association between TM and MACEs was especially high (odds ratio 2.73) and unaffected by the stage of cardiac (≤40, 40<LVEF≤55, 55<%) or renal function (≤40, 40<creatinine clearance≤75, 75<ml/min).
TM is independently associated with MACEs and may be predictive of second events in patients after PCI for ACS. ACS patients with high TM value need strict follow up.</description><subject>Acute coronary syndrome</subject><subject>Endothelial dysfunction</subject><subject>Second event</subject><subject>Thrombomodulin</subject><issn>0914-5087</issn><issn>1876-4738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQxi0EokvhBTggHzmQ4D-J4yAuqIKCVIkD5Wy5kwnrKLEX21m0D8E747AtRzQHj-TffJr5PkJeclZzxtXbqZ4mgFowrmvW1oypR2THdaeqppP6MdmxnjdVy3R3QZ6lNBWA9Vo9JRei17qTQu_I79t9DMtdWMKwzs5TsJ4eIg4OMs17pM6DG9AD0jDShBD8QPGIPqfyRQ82u7_9L5f31MKakUKIwdt4ounkh6KN7-g353_MWEFBMb6hEXMM6YCQ3XHj9yFmmvI6nJ6TJ6OdE764fy_J908fb68-Vzdfr79cfbipQGqWK2jGRkqr2nG0VoJSHHtlNSLTDRNs7FupS3GEvu87wSSyUamGS-xbC2MrL8nrs-4hhp8rpmwWlwDn2XoMazKCtVJ0jRAbKs4olJ1TxNEcolvKfYYzs8VgJrPFYLYYDGtNcbkMvbrXX-8WHP6NPPhegPdnAMuVR4fRJHCbzYOLxRczBPc__T98H5wD</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Kosaki, Ryota</creator><creator>Minoura, Yoshino</creator><creator>Ogura, Kunihiro</creator><creator>Oishi, Yosuke</creator><creator>Tanaka, Lisa</creator><creator>Arai, Ken</creator><creator>Nomura, Kosuke</creator><creator>Sakai, Koshiro</creator><creator>Sekimoto, Teruo</creator><creator>Nisikura, Tenjin</creator><creator>Tsujita, Hiroaki</creator><creator>Kondo, Seita</creator><creator>Tsukamoto, Shigeto</creator><creator>Hamazaki, Yuji</creator><creator>Kobayashi, Youichi</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2595-2043</orcidid></search><sort><creationdate>20181201</creationdate><title>Thrombomodulin can predict the incidence of second events in patients with acute coronary syndrome: Single-center, retrospective cohort study</title><author>Kosaki, Ryota ; Minoura, Yoshino ; Ogura, Kunihiro ; Oishi, Yosuke ; Tanaka, Lisa ; Arai, Ken ; Nomura, Kosuke ; Sakai, Koshiro ; Sekimoto, Teruo ; Nisikura, Tenjin ; Tsujita, Hiroaki ; Kondo, Seita ; Tsukamoto, Shigeto ; Hamazaki, Yuji ; Kobayashi, Youichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-c4f433a65ffaa3c661e96a8ee084020f95383831ec9997203e0f66413e95acf53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute coronary syndrome</topic><topic>Endothelial dysfunction</topic><topic>Second event</topic><topic>Thrombomodulin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kosaki, Ryota</creatorcontrib><creatorcontrib>Minoura, Yoshino</creatorcontrib><creatorcontrib>Ogura, Kunihiro</creatorcontrib><creatorcontrib>Oishi, Yosuke</creatorcontrib><creatorcontrib>Tanaka, Lisa</creatorcontrib><creatorcontrib>Arai, Ken</creatorcontrib><creatorcontrib>Nomura, Kosuke</creatorcontrib><creatorcontrib>Sakai, Koshiro</creatorcontrib><creatorcontrib>Sekimoto, Teruo</creatorcontrib><creatorcontrib>Nisikura, Tenjin</creatorcontrib><creatorcontrib>Tsujita, Hiroaki</creatorcontrib><creatorcontrib>Kondo, Seita</creatorcontrib><creatorcontrib>Tsukamoto, Shigeto</creatorcontrib><creatorcontrib>Hamazaki, Yuji</creatorcontrib><creatorcontrib>Kobayashi, Youichi</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kosaki, Ryota</au><au>Minoura, Yoshino</au><au>Ogura, Kunihiro</au><au>Oishi, Yosuke</au><au>Tanaka, Lisa</au><au>Arai, Ken</au><au>Nomura, Kosuke</au><au>Sakai, Koshiro</au><au>Sekimoto, Teruo</au><au>Nisikura, Tenjin</au><au>Tsujita, Hiroaki</au><au>Kondo, Seita</au><au>Tsukamoto, Shigeto</au><au>Hamazaki, Yuji</au><au>Kobayashi, Youichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thrombomodulin can predict the incidence of second events in patients with acute coronary syndrome: Single-center, retrospective cohort study</atitle><jtitle>Journal of cardiology</jtitle><addtitle>J Cardiol</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>72</volume><issue>6</issue><spage>494</spage><epage>500</epage><pages>494-500</pages><issn>0914-5087</issn><eissn>1876-4738</eissn><abstract>•In ACS patients after PCI, EF, elevated BNP and HbA1c were associated with MACEs by any cause.•Thrombomodulin (TM) levels were significantly associated with MACEs in multivariate analysis.•The association between TM and MACEs was especially high and unaffected by the stage of cardiac or renal function.
Plasma levels of atherothrombosis-related markers such as endothelial biomarkers have been reported to predict the risk of first acute coronary syndrome (ACS) events. Percutaneous coronary intervention (PCI) by balloon angioplasty and stenting established as a treatment for ACS enabled early discharge and early clinic care. The procedure of PCI, however, may itself be associated with arterial injury with endothelial dysfunction. The clinical significance of those biomarkers for second events in patients after PCI has not yet been completely understood to identify patients who need strict follow-up.
After the exclusion of 100 patients (60 deaths during hospitalization, 40 severe renal failure), 400 ACS patients (291 males, 71.1±13.0 years) who had undergone successful PCI followed by biomarker assessment within the first postoperative hour were enrolled. We evaluated atherothrombosis-related biomarkers: thrombomodulin (TM), C-reactive protein (CRP), and D-dimer, prothrombin fragment F1+2, and plasminogen activator inhibitor-1, other than those assessed by routine biochemical tests. The outcome after PCI in ACS patients was assessed by the incidence of major adverse cardiovascular events (MACEs).
MACEs occurred in 112 patients during the follow-up period (813.9±474.8 days). As in previous reports, patients with MACEs showed decreased left ventricular ejection fraction (LVEF) by echocardiography, elevated brain natriuretic peptide and HbA1c than patients without MACEs. Not only these markers but also TM were significantly associated with MACEs in multivariate analysis. There were no significant correlations between MACEs and CRP. The association between TM and MACEs was especially high (odds ratio 2.73) and unaffected by the stage of cardiac (≤40, 40<LVEF≤55, 55<%) or renal function (≤40, 40<creatinine clearance≤75, 75<ml/min).
TM is independently associated with MACEs and may be predictive of second events in patients after PCI for ACS. ACS patients with high TM value need strict follow up.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>29887328</pmid><doi>10.1016/j.jjcc.2018.05.006</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-2595-2043</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acute coronary syndrome Endothelial dysfunction Second event Thrombomodulin |
| title | Thrombomodulin can predict the incidence of second events in patients with acute coronary syndrome: Single-center, retrospective cohort study |
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