European Heart Journal

Highlights of 2020 publications on acute cardiac care–acute coronary syndromes. The statements in this figure are based on individual published articles and do not represent any kind of recommendation. ACS, acute coronary syndrome; CABG, coronary artery bypass grafting; COVID-19, coronavirus disease 19; DAPT, dual antiplatelet therapy; FFR, fractional flow reserve; I/R, ischaemia–reperfusion; IRA, infarct-related artery; MI, myocardial infarction; MINOCA, myocardial infarction with non-obstructive coronary arteries; MVD, multivessel disease; MVO, microvascular obstruction; NSTE-ACS, non-ST segment elevation acute coronary syndrome; PCI, percutaneous coronary intervention; SARS-CoV2, severe acute respiratory syndrome coronavirus 2; SCAD, spontaneous coronary artery dissection; STEMI, ST-segment elevation myocardial infarction; 4UDMI, fourth universal definition of myocardial infarction. Numbers correspond to the references in the text.

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The neutrophil–lymphocyte ratio and incident atherosclerotic events: analyses from five contemporary randomized trials

Nicholas H Adamstein, Jean G MacFadyen, Lynda M Rose, Robert J Glynn, Amit K Dey

doi : 10.1093/eurheartj/ehaa1034

European Heart Journal, Volume 42, Issue 9, 1 March 2021, Pages 896–903

The neutrophil–lymphocyte ratio (NLR) is a readily available inflammatory biomarker that may associate with atherosclerosis and predict cardiovascular (CV) events. The aims of this study are to determine whether the NLR predicts incident major adverse cardiovascular events (MACE) and is modified by anti-inflammatory therapy.

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Immune cell-based cardiovascular risk assessment: spotlight on the neutrophil–lymphocyte ratio

Hendrik B Sager, Wolfgang Koenig

doi : 10.1093/eurheartj/ehaa1104

European Heart Journal, Volume 42, Issue 9, 1 March 2021, Pages 904–906

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Effect of long-term beta-blocker treatment following myocardial infarction among stable, optimally treated patients without heart failure in the reperfusion era: a Danish, nationwide cohort study

Anders Holt, Paul Blanche, Bochra Zareini, Deepthi Rajan, Mohammed El-Sheikh

doi : 10.1093/eurheartj/ehaa1058

European Heart Journal, Volume 42, Issue 9, 1 March 2021, Pages 907–914

We aimed to investigate the long-term cardio-protective effect associated with beta-blocker (BB) treatment in stable, optimally treated myocardial infarction (MI) patients without heart failure (HF).

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Learning whether to subtract beta-blockers: it’s about time

Sean van Diepen, Paul W Armstrong

doi : 10.1093/eurheartj/ehaa1033

European Heart Journal, Volume 42, Issue 9, 1 March 2021, Pages 915–918

Proposed framework for foundational and provisional secondary prevention therapy over time in low-risk post-MI patients. Foundational therapies should be considered in all patients without contraindications, while provisional therapies should be considered in selected patients with comorbidities or post-infarction complications. The horizontal time axis proposes duration of therapies and timeframes for pharmacotherapeutic re-assessment, and should be responsive to the temporal evolution of post-MI risk and events. ADP, adenosine diphosphate receptor inhibitors; ASA, acetylsalicylic acid; CKD, chronic kidney disease; DM, diabetes mellitus; HTN, hypertension; RAAS, renin–angiotensin–aldosterone system; RCT, randomized controlled trials; TG, triglyceride. *Pending guideline recommendations.

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Genome-wide analysis identifies novel susceptibility loci for myocardial infarction

Jaana A Hartiala, Yi Han, Qiong Jia, James R Hilser, Pin Huang

doi : 10.1093/eurheartj/ehaa1040

European Heart Journal, Volume 42, Issue 9, 1 March 2021, Pages 919–933

While most patients with myocardial infarction (MI) have underlying coronary atherosclerosis, not all patients with coronary artery disease (CAD) develop MI. We sought to address the hypothesis that some of the genetic factors which establish atherosclerosis may be distinct from those that predispose to vulnerable plaques and thrombus formation.

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Unfolding and disentangling coronary vascular disease through genome-wide association studies

Jeanette Erdmann, Sander W van der Laan

doi : 10.1093/eurheartj/ehaa1089

European Heart Journal, Volume 42, Issue 9, 1 March 2021, Pages 934–937

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Alarmin-activated B cells accelerate murine atherosclerosis after myocardial infarction via plasma cell-immunoglobulin-dependent mechanisms

Tin Kyaw, Paula Loveland, Peter Kanellakis, Anh Cao, Axel Kallies

doi : 10.1093/eurheartj/ehaa995

European Heart Journal, Volume 42, Issue 9, 1 March 2021, Pages 938–947

Myocardial infarction (MI) accelerates atherosclerosis and greatly increases the risk of recurrent cardiovascular events for many years, in particular, strokes and MIs. Because B cell-derived autoantibodies produced in response to MI also persist for years, we investigated the role of B cells in adaptive immune responses to MI.

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Does a myocardial infarction boost your (B cell) memory?

Claudia Monaco, Jennifer Cole

doi : 10.1093/eurheartj/ehaa1059

European Heart Journal, Volume 42, Issue 9, 1 March 2021, Pages 948–950

Establishment of an autoreactive B cell memory after myocardial infarction: a working hypothesis. The demise of cardiac cells leads to the release of cryptoantigens that induce a humoral immune response that leads to accumulation of immunoglobulins in plaques and eventually amplifies atherogenesis at remote sites.

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