losartan-potassium and Acute-Coronary-Syndrome

Erythropoietin (EPO) is a hematopoietic hormone with extensive nonhematopoietic properties. The discovery of an EPO receptor outside the hematopoietic system has fuelled research into the beneficial effects of EPO for various conditions, predominantly in cardiovascular disease. Experimental evidence has revealed the cytoprotective properties of EPO, and it seems that the EPO-EPO receptor system provides a powerful backbone against acute myocardial ischemia, gaining from the different properties of EPO. There is an ongoing discussion about possible discrepancy between preclinical and clinical effects of EPO on the cardiovascular system. Large, randomized, placebo-controlled clinical trials are underway to give a final verdict on EPO treatment for acute coronary syndromes.

Topics: Acute Coronary Syndrome; Acute Disease; Anemia; Erythropoiesis; Erythropoietin; Humans; Myocardial Infarction; Myocardial Ischemia; Myocardial Reperfusion; Receptors, Erythropoietin; Syndrome

A pilot study was performed to determine the effect of 40,000 IU Epo on myocardial damage in 51 patients with non-ST segment elevation acute coronary syndrome (non-STE ACS). No significant difference in myocardial damage was found, but an increased systolic blood pressure was noticed.

Topics: Acute Coronary Syndrome; Epoetin Alfa; Erythropoietin; Humans; Injections, Intravenous; Myocardial Infarction; Pilot Projects; Prospective Studies; Recombinant Proteins

to investigate the prognostic role of erythropoietin (EPO) in patients with acute coronary syndrome (ACS).. Eighty-four patients (46 men, 38 women, mean age 63+/-11 years) with ACS were studied. Twenty-one patients had ST-elevation myocardial infarction (STEMI), 12 - non-ST-elevation myocardial infarction, 51 - unstable angina (UA). Ten patients with STEMI received thrombolytic therapy. Coronary angiography during hospitalization was criterion for exclusion from the study. Serum EPO was measured at hospital admission.. In-hospital mortality was 5%. Median EPO serum level was higher among patients who died (78.1 [27.8-143.5] vs. 9.0 [6.4-14.1]I.U./ml, p=0.004). Acute kidney injury (AKI) was observed in 7 patients with myocardial infarction (21%) and only in 1 with UA.EPO >10.5 I.U./ml was a significant predictor of AKI development (area under curve 0.73; sensitivity 71%, specificity 67%).. The results of the present study indicate that in patients with ACS admission serum level of EPO may be an important biomarker of development of AKI and in-hospital mortality.

Topics: Acute Coronary Syndrome; Aged; Angina, Unstable; Biomarkers; Coronary Angiography; Erythropoietin; Female; Humans; Male; Middle Aged; Predictive Value of Tests; Prognosis

To investigate the prognostic value of serum endogenous erythropoietin (EPO) in patients with acute coronary syndrome (ACS), including that in the development of acute kidney injury (AKI).. Eighty-four patients (46 men, 38 women; mean age 63 ± 11 years) with ACS were examined. Twenty-one (25%) patents were diagnosed with ECG ST-segment elevation acute myocardial infarction (STSEAMI), 12 (14%) had ECG non-STSEAMI, and 51 (61%) had unstable angina. Thrombolytic therapy was performed in 10 (48%) patients with STSEAMI. The patients whom had not undergone coronarography were included in the investigation to exclude the nephrotoxic effect of X-ray contrast agents.. AKI was observed in 7 of the patients with acute myocardial infarction and in only 1 of those with unstable angina. Four (5%) patients died during hospitalization. The EPO level of > 10.5 IU/ml predicted the development of AKI in the ACS patients with a sensitivity of 71% and a specificity of 67%. That of > 13.7 IU/ml was associated with hospital death in the ACS patients with a sensitivity of 100% and a specificity of 75% (AUC = 0.93%).. High serum EPO levels in an ACS patent during his hospital stay may serve as a biomarker for a high risk for AKI and high death rates.. Цель исследования. Изучить прогностическое значение эндогенного эритропоэтина (ЭПО) сыворотки крови у больных с острым коронарным синдромом (ОКС), в том числе в развитии острого повреждения почек (ОПП). Материалы и методы. Обследовали 84 больных с ОКС (46 мужчин, 38 женщин, средний возраст 63±11 лет). У 21 (25%) пациента диагностирован острый инфаркт миокарда с подъемом сегмента ST (ОИМпST), у 12 (14%) - острый инфаркт миокарда без подъема сегмента ST (ОИМбпST) на электрокардиограмме, у 51 (61%) - нестабильная стенокардия. Тромболитическая терапия проведена 10 (48%) больным с ОИМпST. Для исключения нефротоксичного действия рентгеноконтрастных препаратов в исследование включены больные, которым коронарография не выполнялась. Результаты. Среди больных ОИМ острое повреждение почек наблюдалось у 7, а среди пациентов с нестабильной стенокардией - только у 1. Умерли во время госпитализации 4 (5%) больных. Уровень ЭПО >10,5 МЕ/мл прогнозировал развитие ОПП у больных с ОКС с чувствительностью 71% и специфичностью 67% (AUC=0,73). Уровень ЭПО >13,7 МЕ/мл был ассоциирован со смертью больных с ОКС в стационаре с чувствительностью 100% и специфичностью 75% (AUC=0,93). Заключение. Высокий уровень ЭПО в сыворотке крови у больного с ОКС во время пребывания в стационаре может служить биомаркером высокого риска развития острого повреждения почек и высокой летальности.

Topics: Acute Coronary Syndrome; Acute Kidney Injury; Biomarkers; Coronary Angiography; Electrocardiography; Erythropoietin; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prognosis

Topics: Acute Coronary Syndrome; Adult; Diagnosis, Differential; Doping in Sports; Echocardiography; Electrocardiography; Erythropoietin; Heart Ventricles; Humans; Male; Thrombosis

Topics: Acute Coronary Syndrome; Doping in Sports; Erythropoietin; Heart Ventricles; Humans; Male; Thrombosis

Topics: Acute Coronary Syndrome; Doping in Sports; Erythropoietin; Heart Ventricles; Humans; Male; Thrombosis

Erythropoietin has been related to adverse prognosis in patients with heart failure, but it is unknown whether it adds prognostic information in acute coronary syndrome.. Plasma erythropoietin was measured on admission with enzyme-linked immunosorbent assay in 627 patients. Patients were divided into three groups depending on their erythropoietin level and followed for myocardial infarction (MI) (median 6 months) and mortality (median 39 months). Cox regression models were used to evaluate erythropoietin compared to clinical variables; age, gender, diabetes, smoking, prior MI, heart failure, hypertension and revascularization. In a second Cox regression model, laboratory markers were assessed; hemoglobin, estimated glomerular filtration rate (eGFR), C-reactive protein (CRP), cardiac troponin T (cTnT) and N-terminal pro-brain-natriuretic peptide (NT-proBNP).. Patients with the highest erythropoietin level (>8.8 mU/mL, n=205) had a 47% increased mortality (HR 1.47, 95% CI 1.04-2.06, p=0.028) when adjusted for clinical variables. Compared to laboratory risk markers, erythropoietin added prognostic information (HR 1.59, 95% CI 1.05-2.38, p=0.027) when adjusted for hemoglobin, eGFR and CRP. Erythropoietin (HR 1.21, 95% CI 0.79-1.86, p=0.387) was no longer significantly associated with mortality when cTnT and NT-proBNP were added. Erythropoietin was not related to the risk of future MI (HR 1.24, 95% CI 0.65-2.33, p=0.513).. Elevated erythropoietin level was associated with increased mortality in patients admitted with possible ACS when adjusted for clinical variables, or for kidney function and hemoglobin. However, erythropoietin does not add prognostic information when markers of myocardial necrosis and dysfunction are available in ACS.

Topics: Acute Coronary Syndrome; Aged; C-Reactive Protein; Erythropoietin; Female; Glomerular Filtration Rate; Hemoglobins; Humans; Male; Middle Aged; Myocardial Infarction; Natriuretic Peptide, Brain; Peptide Fragments; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Risk Factors; Troponin T

Erythropoietin (EPO) has been shown to have effects beyond hematopoiesis, such as prevention of cardiac apoptosis. The purpose of the current study is to examine the influence of the time-course change in the serum concentration of endogenous EPO on cardiac functions in the chronic phase in patients with acute coronary syndrome, who successfully achieved reperfusion by primary percutaneous coronary intervention (PCI).. The prospective study included 34 patients with angiographically documented coronary artery disease, including 24 patients with acute myocardial infarction (AMI) and 10 patients with unstable angina pectoris (UAP) who underwent successful PCI within 24 h from the onset. Serum EPO concentration significantly increased at Day 3 and Day 7 compared with that at Day 1 in the AMI group, and the level at Day 3 was significantly higher in the AMI group than in the UAP group. There were significant correlations between DeltaEPO and Delta left ventricular ejection fraction (LVEF) or Delta left ventricular end-diastolic volume index and between peak EPO concentration and DeltaLVEF.. These data showed the time-dependent increase of serum EPO in AMI patients after primary PCI, indicating its possible contribution to cardioprotective effect in the chronic phase.

Topics: Acute Coronary Syndrome; Aged; Angioplasty, Balloon, Coronary; Biomarkers; Coronary Angiography; Erythropoietin; Female; Hemoglobins; Humans; Male; Middle Aged; Prospective Studies; Stroke Volume; Time Factors; Treatment Outcome; Up-Regulation; Ventricular Function, Left