• MeSH
• maratonský běh MeSH
• odměny a ceny MeSH
• zdravotní sestry MeSH
• Publikační typ
• novinové články MeSH
• rozhovory MeSH

• Klíčová slova
• maraton,
• MeSH
• běh * MeSH
• volnočasové aktivity MeSH
• zdravotní sestry MeSH
• Publikační typ
• novinové články MeSH
• rozhovory MeSH
• Geografické názvy
• Londýn MeSH

• MeSH
• běh * MeSH
• vytrvalostní trénink MeSH
• Publikační typ
• novinové články MeSH
• rozhovory MeSH

Úvod: Rozvoj srdečního selhání po infarktu myokardu (IM) je příčinou opakovaných hospitalizací pro akutní dekompenzaci a výrazně zhoršuje kvalitu života. Řada prací prokázala, že natriuretické peptidy stanovené v akutní fázi mohou stratifikovat rizikovost pacientů v dlouhodobém sledování. Doposud nebyl stanoven prognostický význam natriuretických peptidů stanovených u stabilních pacientů po IM s ST elevacemi (STEMI) léčených primární perkutánní koronární intervencí (PCI). Cílem práce bylo pomocí ROC analýzy zjistit přínos mozkového natriuretického peptidu (BNP) a NT-proBNP (N-terminální fragment) k predikci rizika hospitalizace pro akutní srdeční selhání (ASS), celkové mortality a jejich kombinace během 12 a 24 měsíců. Metodika: Ve skupině 317 stabilních pacientů po STEMI léčených primární PCI byla při prospektivně plánované kontrole po 3 měsících stanovena mimo základních biochemických, klinických a echokardiografických (ECHO) parametrů i hladina BNP a NT-proBNP. Medián doby sledování byl 39 měsíců. Výsledky: Zvýšená hodnota BNP ≥ 189 pg/ml, resp. NT-proBNP ≥ 551 pg/ml byla významným prediktorem hospitalizace v následujících 12 měsících (plocha pod křivkou – AUC 0,916, resp. 0,854; obě p < 0,001), resp. 24 měsících (AUC 0,878, resp. 0,885; obě p < 0,001). Zvýšená hodnota BNP, resp. NT-proBNP představovala významný prediktor 12-, resp. 24měsíční mortality (AUC 0,720, resp. 0,793; vše p ≤ 0,025) a kombinovaného cíle za 12, resp. 24 měsíců (AUC 0,791, resp. 0,824; vše p < 0,001). Závěr: Zvýšená hodnota BNP ≥ 189 pg/ml a NT-proBNP ≥ 551 pg/ml u stabilních pacientů 3 měsíce po STEMI léčených primární PCI predikuje zvýšené riziko hospitalizace pro ASS, mortality a kombinovaného klinického endpointu během prvních 2 let. Jednorázové stanovení natriuretických peptidů představuje velmi jednoduchý nástroj k identifikaci těch nejrizikovějších pacientů po IM.

Background: The development of heart failure after myocardial infarction is the cause of repeated hospitalizations for acute decompensation and a factor that significantly reduces quality of life. The prognostic value of natriuretic peptides in stable patients after STEMI treated with primary PCI has not been evaluated so far. The aim of this study was to determine the contribution of BNP or NT-proBNP for the prediction of the risk of hospitalization for acute heart failure, risk of mortality and their combination within 12 and 24 months. Methods: The study population consisted of 317 STEMI patients treated with primary PCI. The levels of BNP and NT-proBNP were measured at a follow-up control after 3 months. Results: The thresholds of BNP ≥ 189 pg/mL or NT-proBNP ≥ 551 pg/mL was a strong predictor of hospitalization over the following 12 months (AUC 0.916 and 0.854, both p < 0.001) and 24 months (AUC 0.878 and 0.855, both p < 0.001). Increased values of BNP and NT-proBNP were a significant predictor of 12- and 24-month mortality, respectively (AUC 0.720, resp. 0.793, all p ≤ 0.025) and a combined end-point at 12 resp. 24 months (ACU 0.791 resp. 0.824, all p < 0.001). Conclusion: The thresholds of BNP≥189 pg/mL and NT-proBNP ≥ 551 pg/ml measured at 3 months after STEMI in stable patients predict an increased risk of hospitalization due to acute heart failure decompensation, mortality and combined clinical endpoint in the first 2 years. Determination of natriuretic peptides is a simple tool to identify high-risk patients after myocardial infarction.

• MeSH
• hospitalizace MeSH
• interpretace statistických dat MeSH
• koronární angioplastika využití   MeSH
• lidé MeSH
• natriuretický peptid typu B * krev   MeSH
• prediktivní hodnota testů MeSH
• prospektivní studie MeSH
• srdeční selhání * mortalita   patofyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

The influence of polymorphisms in the large group of MMP and TIMP genes on clinical outcomes in patients after ST elevation myocardial infarction (STEMI) treated with primary PCI was analysed. In total, 550 consecutive Caucasian patients with STEMI were included in the present study, with a median of 32 months. We analysed 19 polymorphisms in the genes coding MMP and TIMP genes. The MMP-1 -519A/G and -422A/T polymorphisms are associated with combined endpoint after myocardial infarction. The hazard ratio for AT variant of MMP-1 -422A/T was 1.75 (p < 0.001); the variants with at least one A allele of MMP-1 -519A/G have less risk of combined endpoint. The TT variants of -1562C/T MMP-9 and at least one T allele of +92C/T MMP-13 were considered in a trend to affect disease progression and long-term survival after myocardial infarction. According to reclassification analysis NRI and IDI, long-term risk stratification using MMP-1 -422A/T and -519A/G polymorphisms gives additional information to the commonly used GRACE risk score. Patient stratification after myocardial infraction (MI) according to risk genotypes of MMP-1 polymorphisms could have important clinical implications for identification of patients at risk and therapeutic strategies.

• MeSH
• alely MeSH
• dospělí MeSH
• infarkt myokardu s elevacemi ST úseků diagnóza   genetika   MeSH
• koronární angioplastika MeSH
• lidé středního věku MeSH
• lidé MeSH
• matrixová metaloproteinasa 1 genetika   MeSH
• matrixová metaloproteinasa 13 genetika   MeSH
• matrixová metaloproteinasa 9 genetika   MeSH
• polymorfismus genetický MeSH
• prognóza MeSH
• rizikové faktory MeSH
• senioři MeSH
• tkáňové inhibitory metaloproteinas genetika   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: We compared the prognostic capacity of conventional and novel invasive parameters derived from the slope of the preload recruitable stroke work relationship (PRSW) in STEMI patients and assessed their contribution to the TIMI risk score. METHODS: Left ventricular end-diastolic pressure (EDP), ejection fraction (EF), pressure adjusted maximum rate of pressure change in the left ventricle (dP/dt/P), aortic systolic pressure to EDP ratio (SBP/EDP) and end-diastolic volume adjusted stroke work (EW), derived from the slope of the PRSW relationship, were obtained during the emergency cardiac catheterization in 523 STEMI patients. The predictive power of the analyzed parameters for 30-day and 1-year mortality was evaluated using C-statistics and reclassification analysis was adopted to assess the improvement in TIMI score. RESULTS: The highest area under the curve (AUC) values for 30-day mortality were observed for EW (0.872(95% confidence interval 0.801-0.943)), SBP/EDP (0.843(0.758-0.928)) and EF (0.833(0.735-0.931)); p<0.001 for all values. For 1-year mortality the best predictive value was found for EW (0.806(0.724-0.887) and EF (0.793(0.703-0.883)); p<0.001 for both. The addition of EDP, SBP/EDP ratio and EW to TIMI score significantly increased the AUC according to De Long's test. For 30-day mortality, increased discriminative power following addition to the TIMI score was observed for EW and SBP/EDP (Integrated Discrimination Improvement was 0.086(0.033-0.140), p=0.002 and 0.078(0.028-0.128), p=0.002, respectively). CONCLUSIONS: EW and SBP/EDP are prognostic markers with high predictive value for 30-day and 1-year mortality. Both parameters, easily obtained during emergency catheterization, improve the discriminatory capacity of the TIMI score for 30-day mortality.

• MeSH
• hemodynamika MeSH
• hodnocení rizik MeSH
• infarkt myokardu s elevacemi ST úseků diagnóza   mortalita   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• prediktivní hodnota testů MeSH
• prognóza MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• tepový objem fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

OBJECTIVES: Neutrophil gelatinase-associated lipocalin (NGAL) from a pathophysiological perspective connects various pathways that affect the prognosis after myocardial infarction. The objective was to evaluate the benefits of measuring NGAL for prognostic stratification in addition to the Thrombolysis in Myocardial Infarction (TIMI) score, and to compare it with the prognostic value of B-type natriuretic peptide (BNP). DESIGN: Prospective observational cohort study. SETTING: One university/tertiary centre. PARTICIPANTS: A total of 673 patients with ST segment elevation myocardial infarction were treated by primary percutaneous coronary intervention. NGAL and BNP were assessed on hospital admission. OUTCOMES: PRIMARY OUTCOME: 1-year mortality. SECONDARY OUTCOMES: 1-year hospitalisation due to acute heart failure, unplanned revascularisation, reinfarction, stroke and combined end point of 1-year mortality and hospitalisation due to heart failure. STATISTICAL METHODS: Using the c-statistic, the ability of NGAL, BNP and TIMI score to predict 1-year mortality alone and in combination with readmission for heart failure was evaluated. The addition of the predictive value of biomarkers to the score was assessed by category free net reclassification improvement (cfNRI) and the integrated discrimination index (IDI). RESULTS: The NGAL level was significantly higher in non-survivors (67 vs 115 pg/mL; p<0.001). The area under the curve (AUC) values for mortality prediction for NGAL, BNP and TIMI score were 75.5, 78.7 and 74.4, respectively (all p<0.001) with optimal cut-off values of 84 pg/mL for NGAL and 150 pg/mL for BNP. The addition of NGAL and BNP to the TIMI score significantly improved risk stratification according to cfNRI and IDI. A BNP and the combination of the TIMI score with NGAL predicted the occurrence of the combined end point with an AUC of 80.6 or 82.2, respectively. NGAL alone is a simple tool to identify very high-risk patients. NGAL >110 pg/mL was associated with a 1-year mortality of 20%. CONCLUSIONS: The measurement of NGAL together with the TIMI score results in a strong prognostic model for the 1-year mortality rate in patients with STEMI.

• MeSH
• biologické markery krev   MeSH
• elektrokardiografie * MeSH
• infarkt myokardu krev   diagnóza   mortalita   MeSH
• koronární angioplastika * MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipokaliny krev   MeSH
• míra přežití trendy   MeSH
• následné studie MeSH
• natriuretický peptid typu B krev   MeSH
• pooperační období MeSH
• prognóza MeSH
• prospektivní studie MeSH
• proteiny akutní fáze MeSH
• protoonkogenní proteiny krev   MeSH
• ROC křivka MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

Chemokines, including RANTES, play a crucial role in the processes of inflammation during cardiovascular disorders, including myocardial infarction, disease progression and complications. This study aimed to evaluate the role of RANTES -403G/A polymorphism and levels in circulation in processes of development and progression of myocardial infarction and cardiogenic shock. A total of 609 patients with ST-segment elevation myocardial infarction, 43 patients with cardiogenic shock and 130 control subjects were enrolled in the study. RANTES -403G/A promoter polymorphism and baseline serum RANTES levels were analyzed. In the present study, we associated RANTES -403G/A promoter polymorphism with acute heart failure in patients with myocardial infarction (p = 0.006) and ejection fraction 3 months after MI onset (p = 0.02). Further, a difference in circulating RANTES levels among controls and STEMI subjects, and a relation of serum levels with acute heart failure was observed (p = 0.03, p = 0.003, respectively). We found a significant difference when comparing cardiogenic shock patients and controls (p < 0.001), with the most significant difference between cardiogenic shock and AHF subgroup of STEMI patients (p < 0.001). We observed a decreasing tendency of serum RANTES levels with the severity of myocardial infarction and progression, with the lowest levels in patients with cardiogenic shock (cutoff level ≥80.4 ng/ml). Our results suggest the role of RANTES as a potential biomarker of cardiogenic shock and acute heart failure in the hospital phase after myocardial infarction.

• MeSH
• analýza přežití MeSH
• biologické markery krev   MeSH
• chemokin CCL5 krev   genetika   MeSH
• dospělí MeSH
• infarkt myokardu krev   genetika   MeSH
• jednonukleotidový polymorfismus * MeSH
• kardiogenní šok krev   genetika   patologie   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• progrese nemoci MeSH
• promotorové oblasti (genetika) * MeSH
• senioři MeSH
• srdeční selhání genetika   patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

AIM: To compare the prognostic accuracy of six scoring models for up to three-year mortality and rates of hospitalisation due to acute decompensated heart failure (ADHF) in STEMI patients. METHODS AND RESULTS: A total of 593 patients treated with primary PCI were evaluated. Prospective follow-up of patients was ≥3 years. Thirty-day, one-year, two-year, and three-year mortality rates were 4.0%, 7.3%, 8.9%, and 10.6%, respectively. Six risk scores--the TIMI score and derived dynamic TIMI, CADILLAC, PAMI, Zwolle, and GRACE--showed a high predictive accuracy for six- and 12-month mortality with area under the receiver operating characteristic curve (AUC) values of 0.73-0.85. The best predictive values for long-term mortality were obtained by GRACE. The next best-performing scores were CADILLAC, Zwolle, and Dynamic TIMI. All risk scores had a lower prediction accuracy for repeat hospitalisation due to ADHF, except Zwolle with the discriminatory capacity for hospitalisation up to two years (AUC, 0.80-0.83). CONCLUSIONS: All tested models showed a high predictive value for the estimation of one-year mortality, but GRACE appears to be the most suitable for the prediction for a longer follow-up period. The tested models exhibited an ability to predict the risk of ADHF, especially the Zwolle model.

• MeSH
• biologické modely MeSH
• časové faktory MeSH
• hospitalizace MeSH
• infarkt myokardu mortalita   ultrasonografie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• multivariační analýza MeSH
• následné studie MeSH
• plocha pod křivkou MeSH
• prediktivní hodnota testů MeSH
• propuštění pacienta MeSH
• rizikové faktory MeSH
• senioři MeSH
• srdeční selhání diagnóza   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVE: Pentraxin-3 (PTX3) appears to have a cardioprotective effect through a positive influence against postreperfusion damage. This study assesses the prognostic value of PTX3 level and its relationship with clinical parameters and markers of oxidative stress and nitric oxide metabolism in patients with ST-elevation myocardial infarction (STEMI). METHODS: Plasma/serum levels of several biomarkers of inflammation and oxidative stress and nitrite/nitrate were assessed upon admission and 24 h after STEMI onset in patients treated by primary percutaneous coronary intervention. RESULTS: ROC analysis showed that plasma PTX3 at 24 h was a strong predictor of 30-day and 1-year mortality and independent predictor of combined end-point of left ventricle dysfunction or mortality in 1 year. The inflammatory response expressed by PTX3 had a significant relationship with age, heart failure, infarct size, impaired flow in the infarct-related artery, and renal function and positively correlated with neopterin, TNF-α, 8-hydroxy-2'-deoxyguanosine, and nitrite/nitrate. CONCLUSIONS: Plasma PTX3 at 24 h after STEMI onset is a strong predictor of 30-day and 1-year mortality. PTX3 as a single biomarker is comparable with currently used scoring systems (TIMI or GRACE) or B-type natriuretic peptide. PTX3 is also an independent predictor of combined end-point of left ventricle dysfunction or mortality in 1 year.

• MeSH
• biologické markery krev   MeSH
• C-reaktivní protein metabolismus   MeSH
• deoxyguanosin analogy a deriváty   krev   MeSH
• dusitany krev   MeSH
• infarkt myokardu krev   mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• natriuretický peptid typu B krev   MeSH
• neopterin krev   MeSH
• oxidační stres * MeSH
• prediktivní hodnota testů MeSH
• senioři MeSH
• sérový amyloidový protein metabolismus   MeSH
• srdeční selhání krev   mortalita   MeSH
• TNF-alfa krev   MeSH
• troponin I krev   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• práce podpořená grantem MeSH