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1.
Animals (Basel) ; 14(8)2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38672335

RESUMO

This study introduces a novel device designed to monitor dairy cow behavior, with a particular focus on feeding, rumination, and other behaviors. This study investigates the association between the cow behaviors and acceleration data collected using a three-axis, nose-mounted accelerometer, as well as the feasibility of improving the behavioral classification accuracy through machine learning. A total of 11 cows were used. We utilized three-axis acceleration sensors that were fixed to the cow's nose, and these devices provided detailed and unique data corresponding to their activity; in particular, a recorder was installed on each nasal device to obtain acceleration data, which were then used to calculate activity levels and changes. In addition, we visually observed the behavior of the cattle. The characteristic acceleration values during feeding, rumination, and other behavior were recorded; there were significant differences in the activity levels and changes between different behaviors. The results indicated that the nose ring device had the potential to accurately differentiate between eating and rumination behaviors, thus providing an effective method for the early detection of health problems and cattle management. The eating, rumination, and other behaviors of cows were classified with high accuracy using the machine learning technique, which can be used to calculate the activity levels and changes in cattle based on the data obtained from the nose-mounted, three-axis accelerometer.

2.
Curr Med Imaging ; 20: 1-6, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38389367

RESUMO

INTRODUCTION: Follicular Dendritic Cell Sarcomas (FDCS)was first found in 1986; the specificity of the disease is its rarity, with an incidence of only 0.4%, numerous doctors for its lack of understanding, the accuracy of imaging diagnosis is not great, which is easy to delay the treatment. This article summarizes several characteristic imaging manifestations of FDCS to provide imaging physicians with an understanding of the imaging properties of this rare disease. When faced with complex cases, the radiologist can consider this disease and include it in the differential diagnosis. FDCS occurs mainly in lymph nodes, mainly in the head and neck. The main symptoms are fatigue, local pain, or painless mass. The treatment method is not uniform, but scholars agree that we should strive for the opportunity of surgery as much as possible. CASE PRESENTATION: This paper reported a case of FDCS with pelvic recurrence 3 years after surgery. The patient was suspected to have lymphoma by postoperative pathology in the local hospital, and it is recommended that the patient be reexamined regularly. A soft tissue mass was recently found again in the left pelvic cavity. After an enhanced CT examination, the radiologist was skeptical of the previous diagnosis of lymphoma. Subsequently, a needle biopsy was performed at Peking University Shougang Hospital. The pathological results rejected the prior diagnosis of lymphoma after consultation with additional hospitals, and the patient was diagnosed with FDCS. CONCLUSIONS: The imaging manifestations of FDCS lack absolute specificity, but it also has imaging characteristics, such as large areas of necrosis in the huge mass, rough mass calcification in the mass, enhanced scan showed "fast in and slow out" mode, and there were blood vessels in the tumor. FDCS mainly occurs in lymph nodes and is easily misdiagnosed as GIST, inflammatory myoblastoma, lymphoma, etc. Radiologists should continue to collect cases of this disease and include suspected cases in the differential diagnosis in clinical work.


Assuntos
Sarcoma de Células Dendríticas Foliculares , Linfoma , Humanos , Sarcoma de Células Dendríticas Foliculares/diagnóstico por imagem , Sarcoma de Células Dendríticas Foliculares/patologia , Linfonodos/patologia , Diagnóstico Diferencial , Tomografia Computadorizada por Raios X , Linfoma/diagnóstico , Linfoma/patologia
3.
Pharmaceuticals (Basel) ; 16(2)2023 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-37259380

RESUMO

P2Y12 inhibitor monotherapy is a feasible alternative treatment for patients after percutaneous coronary intervention (PCI) in the modern era. Clinical trials have shown that it could lower the risk of bleeding complications without increased ischemic events as compared to standard dual antiplatelet therapy (DAPT). However, the efficacy and safety of this novel approach among patients with acute coronary syndrome (ACS) are controversial because they have a much higher risk for recurrent ischemic events. The purpose of this study is to evaluate the efficacy and safety of this novel approach among patients with ACS. We conducted a meta-analysis of randomized controlled trials that compared P2Y12 inhibitor monotherapy with 12-month DAPT in ACS patients who underwent PCI with stent implantation. PubMed, Embase, the Cochrane library database, ClinicalTrials.gov, and other three websites were searched for data from the earliest report to July 2022. The primary efficacy outcome was major adverse cardiovascular and cerebrovascular events (MACCE), a composite of all-cause mortality, myocardial infarction, stent thrombosis, or stroke. The primary safety outcome was major or minor bleeding events. The secondary endpoint was net adverse clinical events (NACE), defined as a composite of major bleeding and adverse cardiac and cerebrovascular events. Five randomized controlled trials with a total of 21,034 patients were included in our meta-analysis. The quantitative analysis showed a significant reduction in major or minor bleeding events in patients treated with P2Y12 inhibitor monotherapy as compared with standard DAPT(OR: 0.59, 95% CI: 0.46-0.75, p < 0.0001) without increasing the risk of MACCE (OR: 0.98, 95% CI: 0.86-1.13, p = 0.82). The NACE was favorable in the patients treated with P2Y12 inhibitor monotherapy (OR: 0.82, 95% CI: 0.73-0.93, p = 0.002). Of note, the overall clinical benefit of P2Y12 inhibitor monotherapy was quite different between ticagrelor and clopidogrel. The incidence of NACE was significantly lower in ticagrelor monotherapy as compared with DAPT (OR: 0.79, 95% CI: 0.68-0.91), but not in clopidogrel monotherapy (OR: 1.14, 95% CI: 0.79-1.63). Both clopidogrel and ticagrelor monotherapy showed a similar reduction in bleeding complications (OR: 0.46, 95% CI: 0.22-0.94; OR: 0.60, 95% CI: 0.44-0.83, respectively). Although statistically insignificant, the incidence of MACCE was numerically higher in clopidogrel monotherapy as compared with standard DAPT (OR: 1.50, 95% CI: 0.99-2.28, p = 0.06). Based on these findings, P2Y12 inhibitor monotherapy with ticagrelor would be a better choice of medical treatment for ACS patients after PCI with stent implantation in the current era.

4.
Front Plant Sci ; 13: 942359, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35979074

RESUMO

Drought and salt stress can strongly affect the growth and development of wheat. Wheat adapts to drought and salt stress through osmotic regulation. Betaine aldehyde dehydrogenase (BADH) is a key enzyme in the synthesis of betaine, an osmotic regulator. We cloned a region of the TaBADH-A1 promoter and genomic DNA that included the introns and exons, from four Chinese wheat cultivars. Following the analysis of TaBADH-A1 genomic DNA and promoter sequence polymorphisms of 4 cloned and 15 cultivars from the database, 7 haplotypes of TaBADH-A1 gene were identified. We divided the 7 haplotypes with a 254 bp insertion or deletion (indel) into two main alleles, BADH-A1a and BADH-A1b. Meanwhile, a molecular marker was developed based on the 254 bp indel of the third intron of TaBADH-A1 gene. Expression levels of BADH-A1b were found to be significantly higher than those of BADH-A1a under drought and salt stress conditions. Betaine accumulation was significantly higher in wheat containing BADH-A1b compared to BADH-A1a under drought and salt stress. We also identified that the average relative germination and survival rates of wheat with the BADH-A1b allele were significantly higher than wheat with the BADH-A1a allele. The results reveal that wheat containing BADH-A1b has stronger drought and salt tolerance than wheat with BADH-A1a. Meanwhile, the geographic distribution and frequency of the TaBADH-A1 locus alleles indicate that BADH-A1a has been preferred in Chinese wheat breeding programs, while BADH-A1b, associated with favorable stress tolerance, has been neglected. The results of this study provide evidence for an excellent candidate allele for marker-assisted selection of new wheat cultivars with increased salt tolerance and drought resistance.

5.
J Food Drug Anal ; 30(1): 88-103, 2022 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-35647720

RESUMO

A three-step stacking capillary electrophoresis (CE) composed of field-amplified sample injection, sweeping, and analyte focusing by micellar collapse (FASI-sweeping-AFMC) was developed to determine dabigatran (D) and its major active metabolite, dabigatran acyl-beta-d-glucuronide (DAG), in human plasma. After optimization and validation, this novel approach was further applied to monitor 5 real samples, and the 25.2-186.8 ng mL-1 D could be observed among those. Based on these results, the novel CE stacking strategy was successfully applied for the analysis of D and DAG in human plasma and could be served as a tool for clinical assays.


Assuntos
Dabigatrana , Micelas , Eletroforese Capilar/métodos , Humanos
6.
Sci Rep ; 12(1): 10532, 2022 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-35732643

RESUMO

Tumor endothelial marker 1 (TEM1) is a transmembrane glycoprotein that appears on mesenchymal lineage-derived cells during embryogenesis, but its expression greatly reduces after birth. Re-upregulation of TEM1 is found in tumor angiogenesis, organ fibrosis and wound healing indicating its potential role in tissue remodeling and repair. The expression level and function of TEM1 in adult heart are unknown. In explanted hearts from heart failure (HF) patients received cardiac transplantation, immunofluorescence staining showed TEM1 was expressed in cardiomyocytes (CMs) and cardiac fibroblasts. Bioinformatics analysis showed TEM1 upregulation in mouse heart after coronary ligation. Cardiac TEM1 expression was reconfirmed in mouse HF induced by coronary ligation or doxorubicin injection. TEM1 expression increased in cultured CMs stimulated with mechanical stretch, doxorubicin and hypoxia. Further studies showed recombinant TEM1 (rTEM1) was a functional protein that influenced cell behaviors of CMs. It directly activated Erk and Akt through interaction with PDGF receptor. TEM1lacZ/lacZ mice had less collagen deposition and worse cardiac function than wild type mice. These results indicate that TEM1 expression increases in the heart after cardiac injury and works as a functional protein that participates in cardiac remodeling.


Assuntos
Antígenos CD , Antígenos de Neoplasias , Insuficiência Cardíaca , Traumatismos Cardíacos , Miócitos Cardíacos , Remodelação Ventricular , Animais , Antígenos CD/genética , Doxorrubicina/farmacologia , Humanos , Camundongos , Miócitos Cardíacos/metabolismo , Proteínas de Neoplasias/genética , Receptores do Fator de Crescimento Derivado de Plaquetas
7.
Int J Mol Sci ; 23(9)2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35562942

RESUMO

Increasing evidence has shown P2Y12 inhibitor monotherapy is a feasible alternative treatment for patients after percutaneous coronary intervention (PCI) with stent implantation in the modern era. However, patients with diabetes mellitus (DM) have a higher risk of ischemic events and more complex coronary artery disease. The purpose of this study is to evaluate the efficacy and safety of this novel approach among patients with DM and those without DM. We conducted a systematic review and meta-analysis of randomized controlled trials that compared P2Y12 inhibitor monotherapy with 12 months of dual antiplatelet therapy (DAPT) in patients who underwent PCI with stent implantation. PubMed, Embase, Cochrane library database, ClinicalTrials.gov, and three other websites were searched for our data from the earliest report to January 2022. The primary efficacy outcome was major adverse cardiovascular and cerebrovascular events (MACCE): a composite of all-cause mortality, myocardial infarction, stent thrombosis, and stroke. The primary safety outcome was major or minor bleeding events. The secondary endpoint was net adverse clinical events (NACE) which are defined as a composite of major bleeding and adverse cardiac and cerebrovascular events. A total of four randomized controlled trials with 29,136 patients were included in our meta-analysis. The quantitative analysis showed a significant reduction in major or minor bleeding events in patients treated with P2Y12 inhibitor monotherapy compared to standard DAPT (OR: 0.68, 95% CI: 0.46-0.99, p = 0.04) without increasing the risk of MACCE (OR: 0.96, 95% CI: 0.85-1.09, p = 0.50). The number of NACE was significantly lower in the patients treated with P2Y12 inhibitor monotherapy (OR: 0.84, 95% CI: 0.72-0.97, p = 0.019). In DM patients, P2Y12 inhibitor monotherapy was associated with a lower risk of MACCE compared to standard DAPT (OR: 0.85, 95% CI: 0.74-0.98, p = 0.02). Furthermore, P2Y12 inhibitor monotherapy was accompanied by a favorable reduction in major or minor bleeding events (OR: 0.80, 95% CI: 0.64-1.05, p = 0.107). In non-DM patients, P2Y12 inhibitor monotherapy showed a significant reduction in major or minor bleeding events (OR: 0.58, 95% CI: 0.38-0.88, p = 0.01), but without increasing the risk of MACCE (OR: 0.99, 95% CI: 0.82-1.19, p = 0.89). Based on these findings, P2Y12 inhibitor monotherapy could significantly decrease bleeding events without increasing the risk of stent thrombosis or myocardial infarction in the general population. The benefit of reducing bleeding events was much more significant in non-DM patients than in DM patients. Surprisingly, P2Y12 inhibitor monotherapy could lower the risk of MACCE in DM patients. Our study supports that P2Y12 inhibitor monotherapy is a promising alternative choice of medical treatment for patients with DM undergoing PCI with stent implantation in the modern era.


Assuntos
Diabetes Mellitus , Infarto do Miocárdio , Intervenção Coronária Percutânea , Trombose , Diabetes Mellitus/etiologia , Quimioterapia Combinada , Hemorragia/tratamento farmacológico , Hemorragia/etiologia , Humanos , Infarto do Miocárdio/tratamento farmacológico , Intervenção Coronária Percutânea/efeitos adversos , Inibidores da Agregação Plaquetária/efeitos adversos , Antagonistas do Receptor Purinérgico P2Y/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Trombose/etiologia , Resultado do Tratamento
8.
Front Cardiovasc Med ; 9: 1015471, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36588577

RESUMO

Background: Tumor endothelial marker 1 (TEM1/CD248) is a transmembrane protein that expresses in mesenchymal lineage derived cells during embryogenesis and becomes undetectable in normal adults after birth. Re-expression of TEM1 is found in organ fibrosis, wound healing and cardiac remodeling indicating its potential role in heart failure (HF). The purpose of this study is to explore the role of soluble TEM1 (sTEM1) in patients with HF with reduced ejection fraction. Methods: We examined endomyocardial biopsy specimens from three HF patients and blood samples from 48 patients admitted for acute decompensated HF (age 72 years, men 61.7%). The expression of TEM1 in cardiac tissue and concentrations of sTEM1 in plasma were evaluated. Cultured rat cardiomyocytes (H9c2) and human cardiac fibroblasts (HCF) were stimulated with hypoxia or transforming growth factor beta (TGF-ß) to observe the release of sTEM1 into culture media. The conditioned media of hypoxia-stimulated H9c2 cells was harvested and added into cultured cardiac fibroblast to evaluate its biological effect. Results: Immunofluorescence study of biopsy specimens from three HF patients showed TEM1 expression in cardiomyocytes and cardiac fibroblasts. The plasma level of sTEM1 was significantly higher in patients (0.90 ± 0.23 vs. 0.33 ± 0.10 ng/mL, p = 0.032) with LVEF ≤ 35% compared with those with LVEF 36-49%. The sTEM1 levels had correlations with HF biomarkers of cardiac fibrosis, including growth differentiation factor-15 (GDF-15) and galectin-3. There was a significant increase in sTEM1 levels in the cultured media of H9c2 and HCF after being stressed with hypoxia or TGF-ß. The conditioned media derived from hypoxia-stimulated H9c2 cells significantly increased cell proliferation of cardiac fibroblasts. This effect was partially reversed by anti-TEM1 antibody. Conclusion: This pilot study demonstrated that cardiac TEM1 expression was upregulated in HF. The levels of sTEM1 were significantly higher in HF patients with LVEF ≤ 35% and correlated with other biomarkers of cardiac fibrosis. In vitro study proved that functional sTEM1 was released into cultured media after stressing cardiomyocytes and HCF.

9.
PLoS One ; 16(5): e0251109, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33979377

RESUMO

Recent clinical trials showed that short aspirin duration (1 or 3 months) in dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy reduced the risk of bleeding and did not increase the ischemic risk compared to 12-month DAPT in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). However, it is unclear about the optimal duration of aspirin in P2Y12 inhibitor monotherapy. The purpose of this study was to evaluate the influence of aspirin treatment duration on clinical outcomes in a cohort of ACS patients with early aspirin interruption and received P2Y12 inhibitor monotherapy. From January 1, 2014 to December 31, 2018, we included 498 ACS patients (age 70.18 ± 12.84 years, 71.3% men) with aspirin stopped for various reasons before 6 months after PCI and received P2Y12 inhibitor monotherapy. The clinical outcomes between those with aspirin treatment ≤ 1 month and > 1 month were compared in 12-month follow up after PCI. Inverse probability of treatment weighting was used to balance the covariates between groups. The mean duration of aspirin treatment was 7.52 ± 8.10 days vs. 98.05 ± 56.70 days in the 2 groups (p<0.001). The primary composite endpoint of all-cause mortality, recurrent ACS or unplanned revascularization and stroke occurred in 12.6% and 14.4% in the 2 groups (adjusted HR 1.19, 95% CI 0.85-1.68). The safety outcome of BARC 3 or 5 bleeding was also similar (adjusted HR 0.69, 95% CI 0.34-1.40) between the 2 groups. In conclusion, patients with ≤ 1 month aspirin treatment had similar clinical outcomes to those with treatment > 1 month. Our results indicated that ≤ 1-month aspirin may be enough in P2Y12 inhibitor monotherapy strategy for ACS patients undergoing PCI.


Assuntos
Síndrome Coronariana Aguda/tratamento farmacológico , Aspirina/administração & dosagem , Aspirina/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Combinada/métodos , Terapia Antiplaquetária Dupla/métodos , Duração da Terapia , Feminino , Humanos , Masculino , Intervenção Coronária Percutânea/métodos , Inibidores da Agregação Plaquetária/uso terapêutico , Antagonistas do Receptor Purinérgico P2Y/uso terapêutico , Receptores Purinérgicos P2Y12/metabolismo , Taiwan
10.
PLoS One ; 16(4): e0250348, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33891635

RESUMO

The size of a city is not only essential for depicting the scale of the urban system, but also crucial to support the prosperity, order, and high-speed developments. However, its relation to the underlying urban structure has not been empirically investigated in detail. To examine the impact of city size on the city structure and quantify structural features, in this study, a statistical analysis was performed based on network science and an interdisciplinary theoretical system. To obtain the statistical law of internal node layout, the urban system was regarded as a complete graph weighted by the Euclidean distance. The relationship between the urban internal nodes layout (points of interest data, Weibo check-in data, and central point of road intersection data) and the city size was established. The results confirmed the existence of statistical laws in the layout of urban spatial elements, and explored the relationship between the changes in urban node network structure and inequality. This study provided a new perspective of urban structure to understand the complexity of the city, and suggested an approach to adjust this structure to narrow down the gap between the urban and rural areas.


Assuntos
População Rural , Planejamento Social , População Urbana , Cidades , Humanos
11.
Acta Cardiol Sin ; 37(1): 1-8, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33488022

RESUMO

Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor for 6-12 months is the current standard treatment for patients after percutaneous coronary intervention (PCI). However, the optimal DAPT duration is still under debate. A novel strategy with P2Y12 inhibitor monotherapy after PCI has been proposed recently. This strategy shortens the duration of DAPT to 1 to 3 months, followed by monotherapy with a P2Y12 inhibitor instead of aspirin. It has been tested in several clinical trials with promising results. In this article, we reviewed the relevant clinical trial data and the scientific rationale of P2Y12 inhibitor monotherapy with laboratory evidence of platelet inhibition. An early aspirin-free strategy with P2Y12 inhibitor monotherapy seems feasible in some of the patients after PCI.

12.
Front Cardiovasc Med ; 8: 772820, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35284499

RESUMO

Background: Dual antiplatelet therapy (DAPT) score is used to stratify ischemic and bleeding risk for antiplatelet therapy after percutaneous coronary intervention (PCI). This study assessed the association between the DAPT score and clinical outcomes in acute coronary syndrome (ACS) patients who were treated with P2Y12 inhibitor monotherapy. Methods: A total of 498 ACS patients, with early aspirin discontinuation for various reasons and who received P2Y12 inhibitor monotherapy after PCI, were enrolled during the period from January 1, 2014 to December 31, 2018. The efficacy and safety between those with low (<2) and high (≥2) DAPT scores were compared during a 12-month follow-up after PCI. Inverse probability of treatment weighting was used to balance the covariates between the two groups. The primary endpoint was a composite outcome of all-cause mortality, recurrent ACS or unplanned revascularization, and stroke within 12 months. The safety endpoint was major bleeding, defined as Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding. Results: The primary composite endpoint occurred in 11.56 and 14.38% of the low and high DAPT score groups, respectively. Although there was no significant difference in the primary composite endpoint between the two groups in the multivariate Cox proportional hazards models, the risk of recurrent ACS or unplanned revascularization was significantly higher in the high DAPT score group (adjusted hazard ratio [HR]: 1.900, 95% confidence interval [CI]: 1.095-3.295). The safety outcome for BARC 3 or 5 bleeding was similar between the two groups. Conclusions: Our results indicate that ACS patients receiving P2Y12 monotherapy with high DAPT score had an increased risk of recurrent ACS or unplanned revascularization.

13.
Int J Mol Sci ; 21(13)2020 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-32635662

RESUMO

Mesenchymal stem cells (MSCs) have two characteristics of interest for this paper: the ability to self-renew, and the potential for multiple-lineage differentiation into various cells. MSCs have been used in cardiac tissue regeneration for over a decade. Adult cardiac tissue regeneration ability is quite low; it cannot repair itself after injury, as the heart cells are replaced by fibroblasts and lose function. It is therefore important to search for a feasible way to repair and restore heart function through stem cell therapy. Stem cells can differentiate and provide a source of progenitor cells for cardiomyocytes, endothelial cells, and supporting cells. Studies have shown that the concentrations of blood lipids and lipoproteins affect cardiovascular diseases, such as atherosclerosis, hypertension, and obesity. Furthermore, the MSC lipid profiles, such as the triglyceride and cholesterol content, have been revealed by lipidomics, as well as their correlation with MSC differentiation. Abnormal blood lipids can cause serious damage to internal organs, especially heart tissue. In the past decade, the accumulated literature has indicated that lipids/lipoproteins affect stem cell behavior and biological functions, including their multiple lineage capability, and in turn affect the outcome of regenerative medicine. This review will focus on the effect of lipids/lipoproteins on MSC cardiac regenerative medicine, as well as the effect of lipid-lowering drugs in promoting cardiomyogenesis-associated MSC differentiation.


Assuntos
Diferenciação Celular , Regeneração Tecidual Guiada , Coração/fisiologia , Lipídeos/fisiologia , Células-Tronco Mesenquimais/fisiologia , Animais , Humanos , Hipolipemiantes , Medicina Regenerativa
14.
J Clin Med ; 9(6)2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32492818

RESUMO

BACKGROUND: P2Y12 inhibitor monotherapy is an alternative antiplatelet strategy in patients undergoing percutaneous coronary intervention (PCI). However, the ideal P2Y12 inhibitor for monotherapy is unclear. METHODS AND RESULTS: We performed a multicenter, retrospective, observational study to compare the efficacy and safety of monotherapy with clopidogrel versus ticagrelor in patients with acute coronary syndrome (ACS) undergoing PCI. From 1 January 2014 to 31 December 2018, 610 patients with ACS who received P2Y12 monotherapy with either clopidogrel (n = 369) or ticagrelor (n = 241) after aspirin was discontinued prematurely were included. Inverse probability of treatment weighting was used to balance covariates between the groups. The primary endpoint was the composite of all-cause mortality, recurrent ACS or unplanned revascularization, and stroke within 12 months after discharge. Overall, 84 patients reached the primary endpoint, with 57 (15.5%) in the clopidogrel group and 27 (11.2%) in the ticagrelor group. Multivariate adjustment in Cox proportional-hazards models revealed a lower risk of the primary endpoint with ticagrelor than with clopidogrel (adjusted hazard ratio (aHR): 0.67, 95% confidence interval (CI): 0.49-0.93). Ticagrelor significantly reduced the risk of recurrent ACS or unplanned revascularization (aHR: 0.46, 95% CI: 0.28-0.75). No significant difference in all-cause mortality and major bleeding events was observed between the 2 groups. CONCLUSIONS: Among patients with ACS undergoing PCI who cannot complete course of dual antiplatelet therapy, a significantly lower risk of cardiovascular events was associated with ticagrelor monotherapy than with clopidogrel monotherapy. The major bleeding risk was similar in both the groups.

15.
PLoS One ; 14(5): e0215811, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31048901

RESUMO

BACKGROUND: Secondary prevention therapy for patients with coronary artery disease using an antiplatelet agent, ß-blocker, renin-angiotensin system blocker (RASB), or statin plays an important role in the reduction of coronary events after coronary artery bypass grafting (CABG) surgery or percutaneous coronary intervention (PCI). We analyzed the status and effects of secondary prevention after coronary revascularization in Taiwan. METHODS: This national population-based cohort study was conducted by analyzing the Longitudinal Health Insurance Database 2000 from the National Health Insurance Research Database of Taiwan. Patients who underwent CABG or PCI from 2004 to 2009 were included in the analysis. The baseline characteristics of the patients and ACC/AHA class I medication use at 12 months were analyzed. The primary endpoints were a composite of major adverse cardiac and cerebrovascular events. RESULTS: A total of 5544 patients comprising 895 CABG and 4649 PCI patients were evaluated. CABG patients had more comorbidities and a higher rate of major adverse event during the follow-up period. However, use of antiplatelet agents and RASB at 12 months was significantly lower in CABG patients than in PCI patients (44.2% vs. 50.9% and 38.6% vs. 48.9%, both p < 0.01). Age, diabetes, and chronic kidney disease were independent risk factors while statin use was a protective factor for the primary endpoints in both PCI and CABG groups. CONCLUSION: There is still much room to improve class I medication use in secondary prevention for patients after revascularization in Taiwan. Statin could be an effective treatment to improve the outcomes.


Assuntos
Doença da Artéria Coronariana/terapia , Intervenção Coronária Percutânea , Prevenção Secundária , Idoso , Estudos de Coortes , Ponte de Artéria Coronária , Doença da Artéria Coronariana/cirurgia , Bases de Dados Factuais , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Taiwan , Resultado do Tratamento
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