Pancoronary plaque characteristics in STEMI patients with rapid plaque progression: An optical coherence tomography study.

BACKGROUND: Non-culprit plaque progression is associated with recurrent cardiac ischemic events and worse clinical outcomes. Given that atherosclerosis is a systemic disease, the pancoronary characteristics of patients with rapid plaque progression are unknown. This study aims to identify pancoronary plaque features in patients with ST-segment elevation myocardial infarction (STEMI) with and without rapid plaque progression, focused on the patient level. METHODS AND RESULTS: From January 2017 to July 2019, 291 patients underwent 3-vessel optical coherence tomography imaging at the time of the primary procedure and a follow-up angiography interval of 12 months. The final analysis included 237 patients. Overall, 308 non-culprit lesions were found in 78 STEMI patients with rapid plaque progression, and 465 non-culprit plaques were found in 159 STEMI patients without rapid plaque progression. These patients had a higher pancoronary vulnerability (CLIMA-defined high-risk plaque: 47.4% vs. 33.3%; non-culprit plaque rupture: 25.6% vs. 14.5%) and a significantly higher prevalence of other vulnerable plaque characteristics (i.e., lipid-rich plaque, cholesterol crystal, microchannels, calcification, spotty calcification, and thrombus) at baseline versus those without rapid plaque progression. Lesions with rapid progression were highly distributed at the LAD, tending to be near the bifurcation. In multivariate analysis, age ≥ 65 years was an independent predictor of subsequent rapid lesion progression at the patient level, whereas microchannel, spotty calcification, and cholesterol crystal were independent predictors for STEMI patients ≥65 years old. CONCLUSIONS: STEMI patients with subsequent rapid plaque progression had higher pancoronary vulnerability and commonly presented vulnerable plaque morphology. Aging was the only predictor of subsequent rapid plaque progression.

Preparation, antioxidant and antibacterial activities of cryptate copper(II)/sulfonate chitosan complexes.

In this work, we synthesized cryptate copper(II) followed by complexed with sulfonate chitosan (SCS). After characterization, the evaluation of the antioxidant properties of resulting complexes were carried out by 1,1-Diphenyl-2-picrylhydrazyl radical (DPPH•), hydroxyl radical (•OH), and 2,2'-Azinobis-(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS•+), while the antibacterial and biofilm inhibitory activity against Pseudomonas aeruginosa PAO1 (P. aeruginosa PAO1) were also investigated. According to the results, cryptate copper(II) exhibited the best antioxidant activity followed by cryptate copper(II)/SCS complexes, and SCS. Significant antibacterial activity of cryptate copper(II) against P. aeruginosa PAO1 was observed with the minimum inhibitory concentration of MIC value 12.50 µg/mL and minimum bactericidal concentration of MBC value 100.00 µg/mL, followed by cryptate copper(II)/SCS complexes and SCS. Cryptate copper(II) and cryptate copper(II)/SCS exhibited antibacterial activity which copper ions might enter the interior of cells, and the intracellular ions made the killed bacteria serve as an antibacterial agent showing a zombie effect. The copper ions complexed with cryptate and SCS rendering potential unlimited biological activities, might become one of the most popular research areas because of their unique coordination chemistry and their long-term biological activities.

Pharmacometabolomic study of drug response to antihypertensive medications for hypertension marker identification in Han Chinese individuals in Taiwan.

Various groups of antihypertensive drugs targeting different pathways have been developed; however, the pharmacometabolic responses to these drugs have rarely been compared to elucidate the common pathway of blood pressure regulation. Here, we performed a comparative multi-dimensional pharmacometabolic study on the four major lines of antihypertensive drugs, namely angiotensin-converting enzyme inhibitors (ACEis), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), and diuretics (DIURs), through ultra-performance liquid chromatography coupled to quantum time-of-flight mass spectrometry. Two hundred fifty patients with young-onset hypertension, who were equally divided among five study groups: non-medicated, ACEi, ARB, CCB, and DIUR groups, were recruited. In a metabolome-wide association study conducted through analysis of covariance, 37 molecular features significantly associated with pharmacometabolic responses to antihypertensive drugs were identified. One-third of these features were shared by multiple medications. ACEis, ARBs, and DIURs shared more features than CCB, partially reflecting that ACEis, ARBs, and DIURs affect the renin-angiotensin-aldosterone system. Thirteen molecular features were consistently identified by all four models of the analysis of covariance. A tandem mass spectrometry (or MS/MS) experiment was performed to decipher the chemical structure of these 13 molecular features, including ARB-associated lysophosphatidylcholine (P4135), CCB-associated diacylglycerol(15:0/18:2) (P1175), and DIUR-associated oleamide (P1516). In addition, diacylglycerol(15:0/14:2) (P408) was significantly associated with the pharmacometabolic response to all four antihypertensive drugs. The identified metabolites provide insights into the mechanisms of blood pressure regulation and potential predictive markers of pharmacometabolic responses to antihypertensive drugs.

Identification of Serum Oxylipins Associated with the Development of Coronary Artery Disease: A Nested Case-Control Study.

Coronary artery disease (CAD) is among the leading causes of death globally. The American Heart Association recommends that people should consume more PUFA-rich plant foods to replace SFA-rich ones to lower serum cholesterol and prevent CAD. However, PUFA may be susceptible to oxidation and generate oxidized products such as oxylipins. In this study, we investigated whether the blood oxylipin profile is associated with the risk of developing CAD and whether including identified oxylipins may improve the predictability of CAD risk. We designed a nested case-control study with 77 cases and 148 matched controls from a 10-year follow-up of the Nutrition and Health Survey in a Taiwanese cohort of 720 people aged 50 to 70. A panel of 46 oxylipins was measured for baseline serum samples. We discovered four oxylipins associated with CAD risk. 13-oxo-ODE, which has been previously found in formed plagues, was positively associated with CAD (OR = 5.02, 95%CI = 0.85 to 15.6). PGE2/PGD2, previously shown to increase cardiac output, was inversely associated (OR = 0.16, 95%CI = 0.06 to 0.42). 15-deoxy-PGJ2, with anti-inflammatory and anti-apoptosis effects on cardiomyocytes (OR = 0.26, 95%CI = 0.09 to 0.76), and 5-HETE, which was associated with inflammation (OR = 0.28, 95%CI = 0.10 to 0.78), were also negatively associated as protective factors. Adding these four oxylipins to the traditional risk prediction model significantly improved CAD prediction.

Particulate matters, aldehydes, and polycyclic aromatic hydrocarbons produced from deep-frying emissions: comparisons of three cooking oils with distinct fatty acid profiles.

It is recognized that hazardous emissions produced from frying oils may be related to oil properties, particularly the fatty acid composition. However, investigations have been limited and partial. In this work, the emissions from deep-frying foods with three oils (palm, olive, and soybean oils) with distinct fatty acid profiles were comprehensively examined in a simulated kitchen, and the interrelationship among emitted substances, oil quality parameters, and fatty acids profiles was explored. Firstly, palm oil emitted the highest number concentration of total particle matters ((3895 ± 1796) × 103 #/cm3), mainly in the Aitken mode (20-100 nm). We observed a positive correlation between particle number concentration and levels of palmitic acid, a major saturated fatty acid (SAFA) (rs = 0.73, p < 0.05), and total polar compounds (TPC) (rs = 0.68, p < 0.05) in the fried oil, a degradation marker which was also positively correlated with that of black carbon (BC) (rs = 0.68, p < 0.05). Secondly, soybean oil emitted the highest level of gaseous aldehydes (3636 ± 607 µg/m3), including acrolein, propinoaldehyde, crotonaldehyde, hexanal, and trans-2-heptenal; the total aldehyde concentration were positively correlated with α-linolenic acid (ALA) percentage (rs = 0.78, p < 0.01), while hexanal and trans-2-heptenal were with linoleic acid (LA) (rs = 0.73 and 0.67, p < 0.05). LA and ALA were two major polyunsaturated fatty acids in non-tropical plant oils. Thirdly, palm oil emitted the most particle-bound polycyclic aromatic hydrocarbons (PAHs), and a positive association was discovered between two PAHs and SAFA percentage. Olive oil seems superior to soybean and palm oils with regards to toxic emissions during deep-frying.

Prolonged dual antiplatelet therapy in patients with non-ST-segment elevation myocardial infarction: 2-year findings from EPICOR Asia.

BACKGROUND: Patients with non-ST-segment elevation myocardial infarction (NSTEMI) have a generally poor prognosis and antithrombotic management patterns (AMPs) used post-acute coronary syndrome (ACS) remain unclear. Duration of dual antiplatelet therapy (DAPT) and patient characteristics was evaluated in NSTEMI patients enrolled in EPICOR Asia. HYPOTHESIS: Patients stopping DAPT early may benefit from more intensive monitoring. METHODS: EPICOR Asia was a prospective, real-world, primary data collection, cohort study in adults with an ACS, conducted in eight countries/regions in Asia, with 2 year follow-up. Eligible patients were hospitalized within 48 hours of symptom onset and survived to discharge. We describe AMPs and baseline characteristics in NSTEMI patients surviving ≥12 months with DAPT duration ≤12 and > 12 months post-discharge. Clinical outcomes (composite of death, myocardial infarction, and stroke; and bleeding) were also explored. RESULTS: At discharge, 90.8% of patients were on DAPT (including clopidogrel, 99%). At 1- and 2-year follow-up, this was 79.2% and 60.0%. Patients who stopped DAPT ≤12 months post-discharge tended to be older, female, less obese, have prior cardiovascular disease, and have renal dysfunction. While causality cannot be inferred, the incidence of the composite endpoint over the subsequent 12 months was 10.6% and 3.1% with shorter vs longer use of DAPT, and mortality risk over the same period was 8.4% and 1.6%. CONCLUSIONS: Over 90% of NSTEMI patients were discharged on DAPT, with 60% on DAPT at 2 years. Patients stopping DAPT early were more likely to have higher baseline risk and may therefore benefit from more intensive monitoring during long-term follow-up.

Mesenchymal Stromal Cells from Patients with Cyanotic Congenital Heart Disease are Optimal Candidate for Cardiac Tissue Engineering.

Engineered heart tissues (EHTs) are regarded as being the most promising alternative to synthetic materials, and autologous mesenchymal stem cells (MSCs) are widely used as seeding cells. However, few studies have evaluated the feasibility of using MSCs from patients with cyanotic congenital heart disease (C-CHD) as seeding cells for EHTs, in comparison with cells from patients of acyanotic congenital heart disease (A-CHD). In the present study, we cultured MSCs from A-CHD and C-CHD patients in normoxia or hypoxia conditions, and compared their pro-angiogenic, anti-apoptotic and inflammation-modulatory potentials. In vivo, we seeded the cells into collagen patches conjugated with, or without, proangiogenic cytokines, which were used to repair the right ventricular outflow tract (RVOT) of rats. The in vitro results showed that C-CHD MSCs expressed higher levels of VEGFA and VEGFR2, and secreted more pro-angiogenic and anti-inflammatory cytokines under hypoxic conditions. On the other hand, apoptosis-related genes from C-CHD MSCs were modulated adaptably, converting these cells into an anti-apoptotic phenotype. In vivo studies demonstrated that in 4 weeks after RVOT reconstruction, cytokine-immobilized patches seeded with C-CHD MSCs exhibited preserved morphology, prolonged cell survival and enhanced angiogenesis compared to A-CHD MSCs. C-CHD MSCs that undergo "naturally hypoxic precondition" present a better cell source for EHTs, which would provide a promising individualized biomaterial for C-CHD patients.

Effect of chitosan pre-soaking on the growth and quality of yellow soybean sprouts.

BACKGROUND: Soybeans are popularly known as a healthy food in many Asian countries and are mostly consumed as sprouts. The present study aimed to investigate the potential applications of chitosan as a natural growth regulator of soybean sprouts, as well as to determine the variation and composition of nutrients and anti-nutrients of soybean sprouts pre-soaked in different concentrations of chitosan solutions. RESULTS: The hypocotyl length and fresh weight of the soybean sprouts could be positively affected by chitosan treatment. The content changes of bioactive products in chitosan-soaked soybean sprouts were dependent on the concentration of chitosan and germination time. Additionally, the lowest phytic acid content was observed in 8 g kg-1 chitosan-treated soybean sprouts, and the phytic acid content values after 5 days of germination was 1.56 g kg-1 , which was decreased by 79.0% compared to the value in ungerminated soybean. CONCLUSION: Chitosan pre-soaking can increase the hypocotyl length and fresh weight of soybean sprouts and also positively effect the content of bioactive products in sprouts, whereas phytic acid can be partially removed, thereby leading to the enhancement of product quality. Chitosan pre-soaking is an alternative technology for the production of low-cost functional foods, where the dose of chitosan is a key factor. © 2018 Society of Chemical Industry.

Chitosan/cellulose-based beads for the affinity purification of histidine-tagged proteins.

Chitosan/cellulose-based beads (CCBs) for the affinity purification of histidine-tagged proteins were prepared from chitosan/cellulose dissolved in ionic liquid as a solvent, and their structures were characterized by Fourier transform infrared spectroscopy, transmission electron microscopy, and thermogravimetric analysis. The affinity purification was used to separate hexahistidine-tagged (his-tagged) enhanced green fluorescent protein (EGFP) from Escherichia coli. The results showed that Zn2+-CCB exhibited more specific adsorption capacity toward the target protein compared with Ni2+-CCB and Cu2+-CCB. The maximum adsorption of EGFP was 1.84 mg/g of Zn2+-CCB, with 90% purity under the optimized conditions (ionic strength (1.0 M NaCl), pH (7.2) and imidazole concentration (500 mM)). In addition, a regeneration method for the sorbent was further developed by washing with ethylenediaminetetraacetic acid disodium and then reimmobilizing with metal ions. This technique is an alternative method for the purification of his-tagged proteins, making the process more economical, fast, stable, and large batch.

Dietary diversity no longer offsets the mortality risk of hyperhomocysteinaemia in older adults with diabetes: a prospective cohort study.

BACKGROUND AND OBJECTIVE: The increased mortality risk of hyperhomocysteinaemia in diabetes may be mitigated by dietary quality. METHODS AND STUDY DESIGN: The Nutrition and Health Survey in Taiwan of 1999-2000 for elders formed this prospective cohort. Baseline health status, diet and anthropometry were documented and plasma homocysteine and biomarkers for B vitamins measured. Participants without diabetes (n=985) were referent for those who had diabetes or developed diabetes until 2006 (n=427). The effect of homocysteine on mortality risk during 1999-2008 was evaluated. RESULTS: Men, smokers and those with poorer physical function had higher homocysteine, but less so with diabetes. Diabetes incidence was unrelated to homocysteine. In hyperhomocysteinaemia (>=15 vs <15 µmol/L), those with diabetes had an adjusted hazard ratio (HR) (95% CI) for mortality of 1.71 (1.18-2.46); p for interaction between homocysteine and diabetes was 0.005. Without diabetes, but with hyperhomocysteinaemia and a low dietary diversity score (DDS <=4 of 6), where the joint mortality hazard for the greater DDS, (>4) and lower homocysteine (<15) was referent, the HR was 1.80 (1.27-2.54) with significant interaction (p=0.008); by contrast, there was no joint effect with diabetes. The contribution of DDS to mortality mitigation in hyperhomocysteinaemia could not be explained by B group vitamins, even though plasma folate was low in hyperhomocysteinaemic participants. With hyperhomocysteinaemia, heart failure was a major cause of death. CONCLUSIONS: In non-diabetic hyperhomocysteinaemia, a more diverse diet increases survival prospects independent of B group vitamins, but not in hyperhomocysteinaemic diabetes where the cardiomyopathy may be less responsive.

Cinnamon users with prediabetes have a better fasting working memory: a cross-sectional function study.

Working memory (WM) is impaired in prediabetes. We hypothesized that culinary herbs and spices may decrease insulin resistance (IR) and improve WM in prediabetes. Healthy people aged ≥60 years with prediabetes (fasting blood glucose 100-125 mg/dL) (47 men and 46 women) whose food and culinary herb intakes were established with a food frequency questionnaire had body composition assessed and fasting glucose and insulin measured. Working memory and Mini-Mental State Examination (MMSE) were assessed on the same occasion. The contributions to associations between WM and diet, body fat, and IR were estimated by linear regression. Compared with nonusers, cinnamon users had significantly less frequent physical activity (2.9 vs. 4.4 times per week) and more often used fresh ginger (93.3% vs. 64.1%) and ginger in cooking (60.0% vs. 32.1%). Cinnamon users also had a better WM (2.9 vs. 2.5, P < .001). Cinnamon had a significant effect (users were 0.446 higher), but not ginger or curry usage, in predicting WM. For sociodemographic variables, only education (years) was significant in predicting WM (ß = 0.065). Other significant determinants of WM were total fat mass (kilograms) (ß = -0.024) and MMSE (ß = 0.075). After adjustment for age and sex, cinnamon use, education, and MMSE remained significant individual predictors. In the final model, in which all variables listed were adjusted simultaneously, cinnamon users still had a significantly higher WM than nonusers. Cinnamon usage is associated with a better WM, not accounted for by dietary quality or IR, in untreated prediabetes.

Turmeric improves post-prandial working memory in pre-diabetes independent of insulin.

BACKGROUND AND OBJECTIVES: Cognitive impairment develops with pre-diabetes and dementia is a complication of diabetes. Natural products like turmeric and cinnamon may ameliorate the underlying pathogenesis. METHODS: People ≥ 60 years (n=48) with newly-recognised untreated pre-diabetes were randomised to a double-blind metabolic study of placebo, turmeric (1 g), cinnamon (2 g) or both (1 g & 2 g respectively), ingested at a white bread (119 g) breakfast. Observations were made over 6 hours for pre- and post-working memory (WM), glycaemic and insulin responses and biomarkers of Alzheimer's disease (AD)(0, 2, 4 and 6 hours): amyloid precursor protein (APP), γ-secretase subunits presenilin-1 (PS1), presenilin-2 (PS2), and glycogen synthase kinase (GSK-3ß). Differences between natural product users and non-users were determined by Students t and chi square tests; and between pre-test and post-test WM by Wilcoxon signed rank tests. Interaction between turmeric and cinnamon was tested by 2-way ANOVA. Multivariable linear regression (MLR) took account of BMI, glycaemia, insulin and AD biomarkers in the WM responses to turmeric and cinnamon. RESULTS: No interaction between turmeric and cinnamon was detected. WM increased from 2.6 to 2.9 out of 3.0 (p=0.05) with turmeric, but was unchanged with cinnamon. WM improvement was inversely associated with insulin resistance (r=-0.418, p<0.01), but not with AD biomarkers. With MLR, the WM responses to turmeric were best predicted with an R2 of 34.5%; and with significant turmeric, BMI and insulin/glucose AUC beta-coefficients. CONCLUSIONS: Co-ingestion of turmeric with white bread increases working memory independent of body fatness, glycaemia, insulin, or AD biomarkers.

Cognitive impairment and limited dietary diversity or physical inactivity are conjoint precursors of incident diabetes more so in elderly women than men.

OBJECTIVES: To establish whether elderly people with impaired cognition are at greater risk for the de-velopment of type 2 diabetes. DESIGN: Prospective population-based cohort study. SETTING: The El-derly Nutrition and Health Survey in Taiwan (NAHSIT Elderly). PARTICIPANTS: One thousand and four hundred ninety-three diabetes-free people >=65 years were followed for incident diabetes in relation to cognitive status for up to 8 years. MEASUREMENTS: The association between cognitive impairment and diabetes incidence was analyzed with Cox proportional hazards models with exclusion of people who had diabetes within one year of cognitive function assessments. RESULTS: Cognitively-impaired women, but not men, had increased diabetes incidence density (DID). Age, gender, ethnicity and personal behavior adjusted hazard ratios (HR) and 95% confidence intervals (CI) for type 2 diabetes with normal cognition as referent were 2.43 (95% CI: 1.27-4.63) for women and 1.55 (95% CI: 0.48-5.07) for men. These gender differences and the HR significances remained with adjustments for age, ethnicity, financial status, dietary quality as a dietary diversity score, physical function, physical activity, fasting glucose, indices of body composition, body mass index, waist circumference, mid-arm muscle circumference, perceived and mental health status. There were extensive significant interactions with the covariates in women. CONCLUSION: Cognitive impairment in later life is associated with greater risk of type 2 diabetes in women and considerable potential risk enhancement.

Low and high homocysteine are associated with mortality independent of B group vitamins but interactive with cognitive status in a free-living elderly cohort.

Hyperhomocysteinemia and cognitive impairment both predict mortality and partly because of dietary associations. We have hypothesized that for, nutritional reasons, homocysteine and cognition may act jointly to determine elder survival. In a Nutrition and Health Survey in Taiwan (1999-2000), some 1412 representative elderly were followed up for mortality up to 10 years. Cognition was assessed by the Short Portable Mental Status Questionnaire. Food and B vitamin intakes with their biomarkers, and plasma homocysteine, were measured at baseline. The possible effects of cognition on homocysteine-associated mortality were ascertained with Cox proportional-hazards models. Homocysteine was higher in those who were older, male, and single, consumed less fish and tea, and with alcohol and smoking. In models adjusted for these variables, when homocysteine exceeded 14.5 µmol/L, mortality was 1.80-fold more than when <9.3 µmol/L (hazard ratio [HR], 1.80; 95% confidence interval [95% CI], 1.20-2.71). P for trend was 0.002 and interactive with sex (P < .002). However, these homocysteine-mortality associations were dependent on cognition (P = .03); adjustment for food intake or nutrient status made little difference. Homocysteine did not predict cognitive impairment (adjusted OR, 1.40; 95% CI = 0.50-3.93). Vitamins B(1), B(2), and B(6) accounted somewhat for cognitive impairment. Cognition predicted mortality, fully adjusted for available covariates and also for homocysteine (HR, 3.66; 95% CI, 1.64-8.20) but interactively with homocysteine. Thus, the B-group vitamin insufficiency and cognitive impairment associations with premature mortality are confirmed. Yet cognition is inter-related with homocysteine in its association with survival in ways not detectably altered by foods or food-derived vitamins.

Completed preparative separation of alkaloids from Cephaltaxus fortunine by step-pH-gradient high-speed counter-current chromatography.

Cephalotaxine-type alkaloids are the anti-cancer components in twigs, leaves, roots and seeds of Cephalotaxus fortunine. It is very important to use the limited resource by finding an efficient purification technology of the alkaloids. Separation of cephalotaxine-type alkaloids in Cephalotaxus fortunine by step-pH-gradient high-speed counter-current chromatography (step-pH-gradient HSCCC) was studied in this paper. The step-pH-gradient HSCCC was performed on a HSCCC instrument equipped with a 400-mL column, using the upper phase of ethyl acetate-n-hexane-water, with added 0.01% trifluoroacetic acid (TFA) as stationary phase, and the lower phase of ethyl acetate-n-hexane-water, with added 2% NH(4)OH, 0.2% NH(4)OH and 0.05% TFA as mobile phase. For each separation, 800mg of extract of cephalotaxine-type alkaloids was separated to yield 9.3mg of drupacine, 15.9mg of wilsonine, 130.4mg of cephalotaxine, 64.8mg of epi-wilsonine, 12.8mg of fortunine and 35.6mg of acetylcephalotaxine with purities 81.2%, 85.7%, 95.3%, 97.5%, 89.1% and 96.2%, respectively. The recovery of each alkaloid was more than 90%. The structures of the six alkaloids were identified by electrospray ionization mass spectrum (ESI-MS) and (1)H and (13)C NMR.

Isolation and structure determination of a lignan from the bark of Salix alba.

A lignan, sisymbrifolin (1) found in the fruits of Solanum sisymbriflolium has been isolated from the bark extract of Salix alba (Salicaceae). Its structure was elucidated by its direct spectrum data of ESI-MS and one- and two-dimensional NMR spectroscopy for the first time.