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Evaluation of prognostic factors associated to acute coronary syndrome at hospital admission and after 30 days in the study "Strategy of registry in acute coronary syndrome study" (ERICO)

Abstract

Background: Acute coronary syndrome (ACS) is an important cause of hospitalization worldwide. Despite most patients are treated at local hospitals, the vast majority of registries of ACS are set in tertiary facilities. The ERICO study (Strategy of Registry of Acute Coronary Syndrome) has as main objective the evaluation of long-term follow up of patients with ACS admitted at Hospital Universitario, a community based hospital that assisted the population of Butantã. Prognostic factors evaluated in the study include inflammatory biomarkers collected at the moment of de episode of ACS and 30 days after as ultrasensitivity C-reactive protein, IL6, IL10; biomarkers associated to the nitration of proteins as the nitrothyrosine and mieloperoxidase; and biomarkers involved with monocytes/macrophage activation as the monocyte chemoatractant protein 1 (MCP1), IL²1 and netrine1; fast blood glucose at emergency department and a glucose tolerance test after 30 days; renal function evaluated by creatinine at emergency department and microalbuminuria after 30 days; pulse-wave velocity, media-intima thickness (IMT), liver steatosis evaluated by sonography, and retinography 30 days after the ACS episode. Methods: The ERICO study is a prospective cohort, which began in February 2009 and have already include 850 patients with ACS, with the perspective of 1100 patients with ACS in 2013. All consecutive patients, 18 years-old or older, with a diagnosis of ACS and give informed consent are enrolled in the study. Sociodemographics, medical history, clinical examination and information about hospital treatment are obtained at hospital admission and during the follow-up. Further, a brief depression questionnaire (Patient Health Questionnaire-9) is applied. Blood samples are drawn at admission and stored for future analyses. In 30-day, the participant is invited to a follow-up visit, in which medical history is updated and additional blood and urinary samples are collected. Besides, retinography, carotid intima-media thickness, heart rate variability and pulse wave velocity are performed. Questionnaires about food frequency, physical activity and sleep apnea are applied, as well as, data about depressive symptoms. At six months and annually after acute event, information is collected by telephone interview. Expected results: evaluation of main prognostic factors related to ACS, comparing the evaluations obtained at emergency department and after 30 days in the different types of ACS (myocardial infarction with and without ST elevation, and unstable angina) in patients diagnosed at Hospital Universitario a community based hospital. The most important point of the study is the complete evaluation done after 30 days of the ACS episode which will permit the evaluation of the best moment to test several prognostic factors (at emergency department or after 30 days), the measurement of factor associated to nitration of proteins, activation of monocytes/macrophages in the atherosclerotic process, and the use of ultrasensitive troponin I as a biomarker of chronic lesion not evaluated with such scope in the literature regarding its accuracy as a prognostic factor in the ACS. (AU)

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
LACERDA LEOCADIO, PAOLA CAROLINE; DOS REIS MENTA, PENELOPE LACRISIO; SILVA DIAS, MELISSA TAINAN; FRAGA, JULIA RODRIGUES; GOULART, ALESSANDRA CARVALHO; SANTOS, ITAMAR SOUZA; LOTUFO, PAULO ANDRADE; BENSENOR, ISABELA MARTINS; ALVAREZ-LEITE, JACQUELINE ISAURA. Low serum levels of CCL2 are associated with worse prognosis in patients with Acute Coronary Syndrome: 2-year survival analysis. BIOMEDICINE & PHARMACOTHERAPY, v. 109, p. 1411-1416, JAN 2019. Web of Science Citations: 0.

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