Relations of Sex to Diagnosis and Outcomes in Acute Coronary Syndrome
Background The atypical presentation of women with acute coronary syndrome ( ACS ) has been related to delayed diagnosis and treatment, which may explain worse outcome compared with men. Methods and Results We analyzed pooled data of 2520 patients of 2 prospective cohorts in terms of differences in presentation and management of women and men suggestive of ACS . Using logistic regression, we established 2 diagnostic models and tested their diagnostic performance in both sexes separately. Sex‐specific differences in management of patients with ACS were ascertained and a 2‐year follow‐up was performed. Women were older than men (median 67 versus 61 years, P =0.001), had more often dyspnea (2…
Association of MR-proadrenomedullin with cardiovascular risk factors and subclinical cardiovascular disease.
Abstract Aims and background Midregional proadrenomedullin (MR-proADM) is a protein, which exerts various effects on the cardiovascular system. Recent studies underscored its prognostic implications in patients with acute dyspnea and cardiovascular diseases. Therefore, we aimed to determine the distribution of MR-proADM in the general population and to reveal potential associations of MR-proADM with cardiovascular risk factors and measures of subclinical cardiovascular disease. Methods and results MR-proADM plasma concentrations were determined in individuals of the population-based cohort of the Gutenberg Health Study ( N = 5000) using a commercially available fluoroimmunoassay. Individua…
Cardiac Troponins for the Diagnosis of Acute Myocardial Infarction in Chronic Kidney Disease
Background Patients with chronic kidney disease ( CKD ) are at high risk of myocardial infarction. Cardiac troponins are the biomarkers of choice for the diagnosis of acute myocardial infarction ( AMI ) without ST ‐segment elevation ( NSTE ). In patients with CKD , troponin levels are often chronically elevated, which reduces their diagnostic utility when NSTE ‐ AMI is suspected. The aim of this study was to derive a diagnostic algorithm for serial troponin measurements in patients with CKD and suspected NSTE ‐ AMI . Methods and Results Two cohorts, 1494 patients from a prospective cohort study with high‐sensitivity troponin I (hs‐ cTnI ) measurements and 7059 cases from a clinical registr…
Transcriptome-Wide Analysis Identifies Novel Associations With Blood Pressure.
Hypertension represents a major cardiovascular risk factor. The pathophysiology of increased blood pressure (BP) is not yet completely understood. Transcriptome profiling offers possibilities to uncover genetics effects on BP. Based on 2 populations including 2549 individuals, a meta-analyses of monocytic transcriptome-wide profiles were performed to identify transcripts associated with BP. Replication was performed in 2 independent studies of whole-blood transcriptome data including 1990 individuals. For identified candidate genes, a direct link between long-term changes in BP and gene expression over time and by treatment with BP-lowering therapy was assessed. The predictive value of pro…