1,5-Anhydroglucitol as a Marker of Acute Hyperglycemia in Cardiovascular Events.

1,5-anhydroglucitol (1,5-AG) is a biomarker of acute hyperglycemia in diabetology and also in cardiodiabetology. It is used to monitor fluctuating glucose levels. 1,5-AG is a monosaccharide that is biochemically similar to D-glucose and originates from the nutrition. The presence of 1,5-AG in blood and tissue is nearly constant due to reabsorption in the renal proximal tubule. In acute hyperglycemia, renal reabsorption is inhibited by glucose and 1,5- AG is excreted in the urine, while its serum level decreases rapidly. 1,5-AG reflects glucose excursions over 1-3 days to 2 weeks. In this regard, low levels of serum 1,5-AG can be a clinical marker of short- term glycemic derangements such as postprandial hyperglycemia, which is an important risk factor for the pathogenesis of coronary artery disease (CAD) as low levels of 1,5-AG reflect severe plaque calcification in CAD and correlate with high-density lipoprotein cholesterol (HDL-C) levels. For these reasons, 1,5-AG may also be a marker for atherosclerosis; in fact an even better marker than HbA1c or fructosamine which are normally used. 1,5-AG may also be a predictor of cardiovascular disease, left ventricular dysfunction after acute coronary syndrome (ACS), and mortality after ACS. This articles reviews the current knowledge on 1,5-AG related to its use as predictor for cardiovascular events.

Soluble urokinase plasminogen activator receptor in one-year prediction of major adverse cardiac events in patients after first myocardial infarction treated with primary percutaneous coronary intervention.

INTRODUCTION: Soluble urokinase plasminogen activator receptor (suPAR) level reflects the general condition of the organism and was proved to give independent information in risk stratification of patients. The aim of this study was to assess the usefulness of suPAR in the prediction of adverse cardiac events in patients with first myocardial infarction (MI) undergoing primary percutaneous coronary intervention. Additionally, the diagnostic power of suPAR was assessed. MATERIAL AND METHODS: One hundred and thirty-nine of 150 consecutive patients were included in the study. Serum suPAR level (ELISA, Virogates) as well as C-reactive protein (on admission and at discharge) and maximum troponin T (assessed from successive 6-hour periods of blood collection) were measured. In the 1-year follow-up study the following major adverse cardiac events were observed: myocardial infarction, revascularization, stroke and death. RESULTS: Multi-variable analysis revealed prognostic usefulness only for suPAR and glomerular filtration rate: p < 0.0001 and p = 0.018; OR = 2.59 and OR = 0.98 respectively, with area under the curve in receiver operating characteristic analysis for both parameters simultaneously 0.89 (p < 0.0001). There was no correlation between suPAR level and the left ventricular dysfunction parameters or the MI type. CONCLUSIONS: Soluble urokinase plasminogen activator receptor level appears to be an independent useful biomarker for the prediction of major adverse cardiac events early after first myocardial infarction. The biomarker's level seems to have more prognostic than diagnostic power.

The association between galectin-3 and clinical parameters in patients with first acute myocardial infarction treated with primary percutaneous coronary angioplasty.

BACKGROUND: Galectin-3, a biomarker associated with fibrosis and inflammation, has been implicated in development and progression of heart failure (HF) and predicts increased mortality and morbidity in this condition. HF frequently develops after myocardial infarction (MI), contributing to worse outcome. The aim of this study is to assess the association between galectin-3 levels and various clinical parameters in acute phase of first MI treated with primary percutaneous coronary intervention (pPCI) in patients without prior HF. METHODS: We included 145 consecutive patients with first acute MI treated with pPCI with stent implantation. Exclusion criteria were: prior HF, severe valvular diseases, coexisting cancers, connective tissue diseases and cirrhosis. Serum galectin-3 concentration was measured within 3-5 days after onset of acute MI. RESULTS: Thirty-six patients with the highest galectin-3 levels (4th quartile, > 16 ng/mL) were compared to 109 subjects with a biomarker concentration ≤ 16 ng/mL. Elevated galectin-3 levels were more often observed in females, the elderly, subjects with coexisting diabetes, renaldysfunction and permanent atrial fi brillation (AF). Galectin-3 correlated with N-terminal pro-B-type natriuretic peptide (r = 0.27, p < 0.001) and high-sensitivity C-reactive protein (r = 0.20, p < 0.05). Multivariate analysis revealed that only new-onset AF and diuretics treatment during hospitalization were independently associated with galectin-3 levels > 16 ng/mL. CONCLUSIONS: Elevated galectin-3 levels were associated with a higher rate of new-onset AF and diuretics treatment during hospitalization in patients with first MI treated with pPCI without prior HF.

The association between galectin-3 and occurrence of reinfarction early after first myocardial infarction treated invasively.

CONTEXT: Galectin-3, as a biomarker of inflammation and fibrosis, has been reported to be associated with coronary artery disease. OBJECTIVE: The study aimed to assess the relationship between galectin-3 levels and the occurrence of reinfarction early after myocardial infarction (MI). METHODS: The study included 145 consecutive patients with first MI treated invasively. Serum galectin-3 was measured using VIDAS (bioMérieux, Marcy-l'Etoile, France). RESULTS: The independent predictors of reinfarction in our group were as follows: female gender, elevated hs-C-reactive protein and galectin-3 levels (measured both at discharge). CONCLUSIONS: Galectin-3 might be an additional useful biomarker in prediction for reinfarction early after first MI.

[Are accessory breasts a potential cause of diagnostic mistakes? Discussion based on case report]. / Czy piersi dodatkowe moga byc zródlem pomylek diagnostycznych? Dyskusja na podstawie opisu przypadku.

The patient was admitted to the oncology clinic due to the presence of a 3 x 4 cm large tumor in the right axillary region. As the lesion resembled a lipoma, it was surgically excised under general anaesthesia. Histopathologic examination described only physiological breast adenomatous tissue. Accessory breasts usually occur along the 'milk line' which develops in the 6th week of intrauterine life and it extends on the anterior aspect of the body, from the axillary fossa to the groin. Accessory breasts achieve different sizes. They are relatively common in human population (2-6%). In most cases accessory breasts are asymptomatic and cause nothing more than a visible distention which may resemble a tumor. Surgical excision is the treatment of choice due to the risk of development of the same pathological changes as in the normal breast. Histopathologic examination is ubiquitous to ascertain the definite diagnosis.