The role of inflammation in coronary artery calcification.

Vascular calcification is an age-dependent, common finding in human coronary arteries and begins as early as the second decade of life, just after fatty streak formation. Previous studies have showed that the severity of coronary calcification is closely related to atherosclerotic plaque burden and cardiac event rate. In the past few decades, coronary calcification has been considered passive and degenerative. With recent clinical and basic research, however, there is increasing recognition that coronary calcification is an active, regulated process. Current diagnostic methods for coronary artery calcification (CAC) are usually traditional coronary angiography, intravascular ultrasound (IVUS), electron beam computed tomography (EBCT) and multi-slice computed tomography (MSCT) while treatment for patients with calcified coronary arteries is troublesome. Several lines of evidence suggest that inflammation plays a major role in the development of atherosclerosis as well as its clinical manifestations. Recent study showed that inflammatory process might be also involved in coronary calcification. Accordingly, measurements of inflammatory markers such as C-reactive protein (CRP) may in part reflect indices of atherosclerosis, such as coronary calcification, and are likely to provide distinct information regarding cardiovascular risk. In this article, we review the current evidence of relationship between coronary calcification and inflammation for purpose of drawing the more attention on the inflammatory mechanism of coronary calcification, which may change our research as well as therapeutic strategies for coronary calcification in the future.

[Electrocardiogram analysis in high risk population of unexplained sudden death in Yunnan province].

OBJECTIVE: The purpose of this study was to analyze the electrocardiographic features of the people living in the area with high incidence of unexplained sudden deaths in Yunnan province. METHOD: The electrocardiograms of 338 residents from three villages (Dayao, Ninglang, Heqing) with high incidence of unexplained sudden deaths and one control village (Dali) were analyzed [averaged age was (33.4 +/- 11.7) years, 175 men and 163 women]. RESULTS: The incidence of cardiac arrhythmias was similar low in all groups. The left ventricular hypertrophy was observed in 34.6% of residents from Dayao. QTc significantly prolonged in the residents from all 3 high incidence areas compare the control area of Dali [control (386.8 +/- 27.22) ms, Ninglang (428.92 +/- 25.71) ms, Heqing (440.67 +/- 28.03) ms, Dayao (417.7 +/- 24.00) ms, P < 0.05 vs. control]. Incidence of U wave was significantly higher in Heqing village than that in control village (P < 0.05). The QUc of these 3 villages was: (613.67 +/- 37.34) ms, (597.19 +/- 46.47) ms, (608.59 +/- 39.59) ms respectively, and also significantly longer than the control village of Dali (589.33 +/- 41.27) ms (P < 0.05). The typical pattern of U wave presents as enlarged U wave and apparent T-U complex. In the 7 residents who have the family history of unexplained sudden death, 6 residents have U wave, and 4 of them present typical U wave pattern. CONCLUSION: The significant ECG changes in villages with high incidence of unexplained sudden death in Yunnan province were prolonged QTc, enlarged U wave and apparent T-U complex and these ECG features suggested the repolarization abnormalities of the heart in these subjects.

[Complications in selective percutaneous coronary interventions: analysis of 2,868 cases].

OBJECTIVE: This report provides analysis of the complication rates, the risk factors, prevention and treatments of the complications of selective coronary interventions. METHODS: The types, the incidence, and the annual distribution characteristics of the complications in 2 868 cases of coronary interventions performed from October 1987 to December 2000 were reviewed, and the risk factors, prevention and treatments of the complications were analyzed. RESULTS: During the study period, 2 868 procedures of percutaneous coronary interventions (PCI) were performed. The total complication rate of PCI was 8.30% (6.33% - 20.00%). The procedure-related mortality rates were 0.07%. The complications included non-fatal Q wave myocardial infarctions (0.17%), coronary artery dissecting (2.58%), acute coronary artery occlusion (1.99%), coronary artery thrombosis (0.38%), coronary artery spasm (1.32%), coronary artery perforation (0.31%), severe arrhythmia (0.63%), severe contrast allergic reaction (0.07%), peripheral vascular complication (0.90%), and heart failure (0.10%). Emergent coronary artery bypass surgery (CABG) was required in 0.10% of the patients with PCI. The independent risk factors of the complications of PCI included unstable angina, coronary multivessel disease, and heart failure. CONCLUSIONS: The complication rates of PCI decreased with the accumulation of experiences. The complication rates in this group of patients are lower than the reported ones. This result is probably due to strictly selecting the indication, actively preventing and treating the complications.

[Complications in selective coronary angiography: analysis of 9196 cases].

OBJECTIVE: To study the incidence rates, risk factors, prevention and treatments of complications of selective coronary arteriography. METHODS: A retrospective survey was conducted on the data of the incidence and annual distribution characteristics of complications among 9 196 cases that underwent selective coronary arteriography performed October 1987 to December 2000, and analyze the risk factors and prevention and treatment of these complications. RESULTS: The total complication rate was 1.33%. The procedure-related mortality rates were 0.02%. The incidence rate of non-fatal Q wave myocardial infarction, coronary artery spasm, severe arrhythmia, severe contrast allergic reaction, peripheral vascular complication, and heart failure in coronary arteriography was 0.01%, 0.13%, 0.29%, 0.04%, 0.35%, and 0.08%, respectively. No emergent coronary artery bypass surgery was required in patients with coronary arteriography. The independent risk factors of the complications of coronary arteriography included unstable angina, coronary multivessel disease, left main coronary artery disease and heart failure. CONCLUSION: The complication rate of coronary arteriography decrease with the accumulation of experience. The complication rate in this group is lower than in other reports probably due to strictly selecting of indication and active prevention and treatment of complications.