Left atrial area index predicts adverse cardiovascular events in patients with unstable angina pectoris

Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index （LAAI） has predictive value for prognosis in patients with unstable angina pectoris （UAP）. This study was aimed to assess the association between LAAI and outcomes in UAP patients. Methods We enrolled a total of 391 in-hospital patients diag- nosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of ad- verse cardiovascular （CV） events, including hospital readmission for angina pectoris, acute myocardial infarction （AMI）, congestive heart failure （CHF）, stroke and all-cause mortality. Results During a mean follow-up time of 26.3±8.6 months, 98 adverse CV events occurred （84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality）. In a multivariate Cox model, LAAI [OR： 1.140, 95% CI： 1.01±1.279, P = 0.026], diastolic blood pressure （OR： 0.976, 95% CI： 0.956-0.996, P = 0.020） and pulse pressure （OR 1.020, 95% CI： 1.007-1.034, P = 0.004） were independent predictors for adverse CV events in UAP patients. Conclusions LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.

Prognostic differences of catestatin among young and elderly patients with acute myocardial infarction

BACKGROUND:Previous studies have reported inconsistent findings regarding the association between catestatin and outcomes of acute myocardial infarction(AMI).This study aims to investigate the prognostic value of catestatin for long-term outcomes in patients with AMI.METHODS:One hundred and sixty-five patients with AMI were enrolled in this series.The plasma catestatin levels at baseline and clinical data were collected.All patients were followed up for four years to investigate whether there were major adverse cardiovascular events(MACEs),including cardiovascular death,recurrent AMI,rehospitalization for heart failure,and revascularization.RESULTS:There were 24 patients who had MACEs during the follow-up period.The MACEs group had significantly lower plasma catestatin levels(0.74±0.49 ng/m L vs.1.10±0.79 ng/m L,P=0.033)and were older(59.0±11.4 years old vs.53.2±12.8 years old,P=0.036).The rate of MACEs was significantly higher in the elderly group(≥60 years old)than in the young group(<60 years old)(23.8%[15/63]vs.8.8%[9/102],P=0.008).The catestatin level was significantly lower in the MACEs group than that in the non-MACEs group(0.76±0.50 ng/m L vs.1.31±0.77 ng/m L,P=0.012),and catestatin was significantly associated with MACEs(Kaplan Meier,P=0.007)among the elderly group,but not in the young group(Kaplan Meier,P=0.893).In the Cox proportional hazards regression,high catestatin was one of the independent factors for predicting MACEs after adjustment for other risk factors(hazard ratio 0.19,95%confidence interval 0.06–0.62,P=0.006)among elderly patients.CONCLUSIONS:Elderly AMI patients with lower plasma catestatin levels are more likely to develop MACEs.Catestatin may be a novel marker for the long-term prognosis of AMI,especially in elderly patients.