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Risk stratification in acute coronary syndromes
Published in K Sarat Chandra, AJ Swamy, Acute Coronary Syndromes, 2020
Avanti Gurram Reddy, Gianluca Rigatelli, Ramesh Daggubati
Acute coronary syndrome (ACS) remains the most severe form of cardiovascular disease and accounts for one third of all global deaths. It also represents the most important basis of chronic heart failure – one of the most problematic and the most frequent chronic diseases, which causes perpetual debility. All-cause mortality at 2 years amounted to 6.2% among patients with AMI, and rates of rehospitalisation due to ACS and revascularisation were 6.8% and 4.1%, respectively [1]. CAD epidemiology in India is characterised by premature occurrence in the young and low-/middle-income group, high mortality and high prevalence of diabetes compared to the west. In the spectrum of ACS, 30 days in-hospital mortality of STEMI patients is higher in the first 2 hours after onset before patients reach the hospital compared to stable ischaemic heart disease post-PCI mostly due to arrythmias, hemodynamic instability and/or lack of early reperfusion procedures. Hence, it is noteworthy to develop strategies to prevent/reduce MACE (major adverse cardiac events) and complications. There is a lack of availability of satisfactory diagnostic markers and appropriate treatment for high-risk versus low-risk patients. In order to manage the potential complications of ACS, considering limited invasive facilities and high recurrence of events, risk stratification is clinically reasonable. The most widely validated risk models for patients with ACS are TIMI (Thrombolysis in Myocardial Infarction), dynamic TIMI, APEX AMI (Assessment of Pexelizumab in Acute Myocardial Infarction), CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) and GRACE (Global Registry of Acute Cardiac Events) algorithms.
Systematic analysis of the varied designs of 819 therapeutic antibodies and Fc fusion proteins assigned international nonproprietary names
Published in mAbs, 2022
Sequences of 24 Fc fusion proteins and two antibodies were found only in INN lists. The Thera-SAbDab database contains only sequences of variable regions. The IMGT database contains full-length sequences, but in a format which was difficult to download and analyze because the sequences are separated into functional regions. Therefore, we only compared the IMGT sequences of variable regions. The Inxight database contained contiguous full-length protein sequences. It included sequences from 44 INNs that were not provided in the INN lists. They were compared with sequences published in the patent literature. No perfect matches were found for lemalesomab (H + L chains), pexelizumab (scFv), tacatuzumab (H chain) or tucotuzumab (H chain) and several others matched only a few patent families. These are all included in our analysis of Fc variants but flagged as “unverified”. A substantial number of INN sequences are reproduced in patent application US2020/0023076. However, it includes numerous alternate sequences with no indication which is correct, and so was not considered to be a reliable guide. We considered two other databases which contain sequences of protein drugs, ChEMBL25 and KEGG,26 but they did not add any significant amount of additional data.
Chronic kidney disease predicts atrial fibrillation in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention
Published in Acta Cardiologica, 2019
Răzvan Constantin Șerban, Ioana Șuș, Eva Katalin Lakatos, Zoltan Demjen, Alexandru Ceamburu, Paul Ciprian Fișcă, Cristina Somkereki, Laszlo Hadadi, Alina Scridon
Despite major advances in STEMI management, AF continues to represent a common complication of STEMI, with an overall incidence of STEMI-related AF of 10.5% and an incidence of new-onset AF of 7.0% in the present study. These results are in line with those from the larger Osaka Acute Coronary Insufficiency Study (OACIS) [1] and Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trials [19]. In addition, both STEMI-related AF and new-onset AF were independently associated with higher in-hospital mortality rates, emphasising the need to deepen our understanding of how this arrhythmia occurs and to identify the most relevant AF predictors in the setting of STEMI.
The use of hemodynamics to predict mortality in patients undergoing primary PCI for ST-elevation myocardial infarction
Published in Expert Review of Cardiovascular Therapy, 2018
Allie E Goins, Robert Rayson, Michael Yeung, George A Stouffer
In the PPCI era, SBP and HR remain important predictors of mortality in STEMI. The Assessment of Pexelizumab in Acute Myocardial Infarction Trial (APEX-AMI) study enrolled 5745 patients with STEMI undergoing primary PCI within 6 h of symptom onset (Table 1) [15]. SBP (HR, 0.86/10-mm Hg increments; 95% CI, 0.82 to 0.90), Killip class (class 3 or 4 vs. 1 or 2) (HR, 4.24; 95% CI, 2.97 to 6.08), and heart rate (> 70 bpm) (HR, 1.45/10-beat increments; 95% CI, 1.31 to 1.59) were independent predictors of 90-day mortality.