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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Double-Stranded DNA and NETs Components in Relation to Clinical Outcome After ST-Elevation Myocardial Infarction.

Miriam Sjåstad Langseth1,2, Ragnhild Helseth3,4, Vibeke Ritschel3

  • 1Center for Clinical Heart Research, Oslo University Hospital Ullevål, PB 4956 Nydalen, 0424, Oslo, Norway. m.s.langseth@studmed.uio.no.

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|March 21, 2020
PubMed
Summary
This summary is machine-generated.

Circulating double-stranded DNA (dsDNA), a marker related to neutrophil extracellular traps (NETs), is linked to higher mortality in ST-elevation myocardial infarction (STEMI) patients. While dsDNA shows prognostic value for death, its association with hypercoagulability is weak.

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Simplified Human Neutrophil Extracellular Traps NETs Isolation and Handling
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Area of Science:

  • Cardiovascular Medicine
  • Immunology
  • Thrombosis Research

Background:

  • Neutrophil extracellular traps (NETs) are increasingly recognized for their role in atherothrombosis.
  • The prognostic significance of circulating NETs-related components in ST-elevation myocardial infarction (STEMI) remains unclear.

Purpose of the Study:

  • To investigate the association between circulating NETs-related components and clinical outcomes, including mortality and hypercoagulability, in STEMI patients undergoing percutaneous coronary intervention (PCI).

Main Methods:

  • An observational cohort study included 956 STEMI patients admitted for PCI.
  • Serum samples collected post-PCI were analyzed for double-stranded DNA (dsDNA), myeloperoxidase-DNA, and citrullinated histone 3.
  • Patients were followed for a median of 4.6 years for major adverse cardiovascular events and mortality.

Main Results:

  • While specific NETs markers (myeloperoxidase-DNA, citrullinated histone 3) did not differ significantly, elevated dsDNA levels were observed in patients who died.
  • Above-median dsDNA was associated with a higher number of deaths.
  • Higher quartiles of dsDNA showed a significant association with increased all-cause mortality (adjusted HRs ranging from 1.89 to 2.28).
  • dsDNA exhibited a weak correlation with D-dimer, suggesting a limited link to hypercoagulability.

Conclusions:

  • Circulating dsDNA, a component associated with NETs, is a significant predictor of all-cause mortality in STEMI patients.
  • The prognostic value of dsDNA in STEMI warrants further investigation, though its association with hypercoagulability is weak.