Low serum levels of CCL2 are associated with worse prognosis in patients with Acute Coronary Syndrome: 2-year survival analysis.

Inflammation is very important in Acute Coronary Syndrome (ACS) as well as in cardiac remodeling after an acute myocardial infarction (MI). Our study examined the prognostic value of Chemokine (C-C motif) ligand 2 (CCL2) in patients with ACS in the ERICO (Strategy of Registry of Acute Coronary Syndrome) study. We evaluated serum samples from 803 patients. The prognostic value of CCL2 was evaluated at the 2-year follow-up, according to cutoff points established by the median. Kaplan-Meier curves and Cox regression were used for analysis of all-cause mortality, cardiovascular mortality, and a combined outcome of fatal myocardial infarction or new non-fatal MI. There were 115 deaths from all causes, 78 deaths due to cardiovascular causes and 67 events in combined outcomes. CCL2 levels below the median (≤100.9 pg/mL) were associated with increased risk of MI death or new non-fatal MI, even after model adjustment. Low serum levels of CCL2 shows a significant association with fatal or new non-fatal MI.

Nutrition status of patients with chronic hepatitis B or C.

OBJECTIVE: Nutrition disorders in patients with chronic liver disease have become a recent concern because these disorders influence outcomes. We investigated patients' nutrition status, included consecutively in the last 2 years to the study, and related the results with the severity of liver disease. METHODS: A total of 230 patients with hepatitis B (n = 80) or C (n = 150) were evaluated by the subjective global assessment (SGA) and body mass index (BMI). The risk of metabolic complications was assessed by waist circumference (WC) and the percentage of body fat (%BF). Alcohol abuse was defined as daily consumption >20 g and >30 g for women and men, respectively. RESULTS: The mean age was 54 years, with 52.6% women, 75% patients without cirrhosis, and 15% patients with cirrhosis. According to the SGA, 86.5% of patients were nourished, and 13.5% were malnourished. Malnutrition was associated with cirrhosis (prevalence ratio [PR], 1.25; 95% confidence interval [CI], 1.1-1.4; P < .001), alcohol abuse, direct bilirubin >3.0 mg/dL, international normalized ratio >1.1, platelet <150 × 10(3)/mm(3), hemoglobin <12 g/dL, and serum albumin <3.5 g/dL (P < .05). According to the BMI, 43.9% of patients were eutrophic, 33.5% were overweight, 21.3% were obese, and 1.3% were underweight. Obese patients had a higher prevalence of steatosis than eutrophic (PR, 1.53; 95% CI, 1.15-2.04; P = .003) and overweight (PR, 1.71; 95% CI, 1.33-2.20; P < .001) patients. Overweight/obesity was associated with WC >94 cm (men) and >80 cm (women), %BF >25% (men) and >32% (women) (P < .01), triglyceride >150 mg/dL, high-density lipoprotein cholesterol <40 mg/dL, glucose >99 mg/dL, insulin >20 µU/mL, homeostatic model assessment-insulin resistance >3.2, and thyroid-stimulating hormone >2.5 µU/mL (P < .05). CONCLUSIONS: Overweight/obesity is prevalent among patients with hepatitis B and C and can contribute to the development of steatosis. Malnutrition is also observed and is related to the severity of liver disease.