Efficacy of interventional closure therapy on cryptogenic stroke with coexisting patent foramen ovale in young patients and its impact on serum fibrinogen and D-dimer levels.

OBJECTIVE: To explore the efficacy of interventional closure therapy in young patients with cryptogenic stroke and coexisting patent foramen ovale and analyze its impact on serum fibrinogen and D-dimer levels. METHODS: All subjects in this study were young stroke patients with PFO. After excluding patients who did not meet the inclusion criteria, they were registered and divided into two groups based on the treatment method: the closure group and the medical group. RESULTS: There were no significant differences in basic clinical data between the two groups, indicating comparability (p > 0.05). The closure group showed better heart function after treatment compared to the medical group, with significant differences (p < 0.05). Headache symptoms in the closure group were less severe than those in the medical group after treatment, with significant differences (p < 0.05). Laboratory indicators in the closure group were better than those in the medical group after treatment, with significant differences (p < 0.05). Serum fibrinogen and D-dimer levels in the closure group were lower than those in the medical group after treatment, with significant differences (p < 0.05). CONCLUSION: Interventional closure therapy demonstrated positive effects on young patients with cryptogenic stroke and coexisting PFO, showing improvements in heart function, headache symptoms, and blood coagulation parameters. While the study suggests potential benefits, cautious interpretation is warranted, given the observational study design. Further research with a larger sample size and long-term follow-up is needed to validate these findings.

Naringenin promotes angiogenesis of ischemic myocardium after myocardial infarction through miR-223-3p/IGF1R axis.

Introduction: Naringenin exerts a protective effect on myocardial ischemia and reperfusion. It has been reported that miR-223-3p is a potential target for the treatment of myocardial infarction (MI). In view of the unreported correlation between Naringenin and miR-223-3p, this study was designed to confirm that the ameliorative effects of Naringenin on MI is directly related to the regulation of miR-223-3p. Methods: Through electrocardiogram detection, Masson pathological staining and immunohistochemistry of angiogenesis-related factors, alleviative effects of Naringenin on heart function, myocardial injury and angiogenesis in MI mice were observed individually. Hypoxic HUVECs were selected in the in vitro experimental model. The cell viability, angiogenesis and migration ability were analyzed to fathom out the pro-angiogenesis potential of Naringenin. The effect of Naringenin on miR-223-3p, as well as the downstream molecular mechanism was verified through bioinformatics analysis and rescue experiments. Results: Naringenin improved heart functions of MI mice, reduced degree of myocardial fibrosis, stimulated expressions of angiogenic factors and down-regulated level of miR-223-3p in myocardial tissue. In in vitro experiments, Naringenin increased the viability of hypoxic HUVECs, as well as the abilities of tube formation and migration, and further inhibited the expression of miR-223-3p. In the rescue trial, miR-223-3p mimic reversed the therapeutic effect of Naringenin. Type 1 insulin-like growth factor receptor (IGF1R), as a downstream target gene of miR-223-3p, partially offset the cellular regulatory effects of miR-223-3p after overexpression of IGF1R. Conclusions: Naringenin improves the angiogenesis of hypoxic HUVECs by regulating the miR-223-3p/IGF1R axis, and has the potential to promote myocardial angiogenesis in MI mice.

Association between total ischemic time and in-hospital mortality after emergency PCI in patients with acute ST-segment elevation myocardial infarction: a retrospective study.

BACKGROUND: Symptom-to-balloon time (SBT) represents the total ischemic time in ST-elevated myocardial infarction (STEMI) and is associated with poor long-term outcomes. The study aimed to explore the association between SBT and in-hospital mortality after emergency percutaneous coronary intervention (PCI) in patients with acute STEMI. METHODS: This retrospective, multicenter, observational study included patients admitted to the Hebei General Hospital, Baoding No. 1 Central Hospital, and Cangzhou Central Hospital from January 2016 to December 2018. The outcome was all-cause mortality during the hospital stay. Logistic regression models were established to explore the association between SBT and all-cause mortality during the hospital stay. RESULTS: This study included 1169 patients: 876 males of 59.6 ± 11.4 years of age, and 293 females 66.3 ± 13.3 years of age. A first analysis showed EF had an interaction with SBT (P = 0.01). In patients with EF ≥ 50%, SBT was not an independent risk factor for postoperative all-cause mortality in the hospital (all P > 0.05). In patients with EF < 50%, SBT was an independent risk factor for postoperative all-cause mortality in the hospital [model 3: 1.51 (1.17, 1.54), P for trend = 0.01]. CONCLUSIONS: SBT was independently associated with all-cause mortality in the hospital after PCI in patients with acute STEMI and EF < 50%. Specifically, the risk of in-hospital mortality for those with SBT ≥ 361 min is increased by 51% compared with those with SBT ≤ 120 min.

Prognostic value of the SYNTAX score on myocardial injury and salvage in STEMI patients after primary percutaneous coronary intervention: a single-center retrospective observational study.

BACKGROUND: SYNTAX score (SS) was shown to positively correlate with postprocedural myocardial injury in patients after elective coronary artery intervention, but evidence about the association of SS with myocardial salvage in ST-segment elevation myocardial infarction (STEMI) patients is still needed. This study aimed to evaluate the prognostic value of SS for myocardial injury and salvage assessed by cardiac magnetic resonance (CMR) after primary percutaneous coronary intervention (PCI) in STEMI patients. METHODS: This single-center retrospective study consecutively enrolled STEMI patients who had undergone primary PCI within 12 h from symptom onset. Both angiography and CMR were performed during hospitalization, and patients were divided into low SS (SS ≤ 22), mediate-high SS (SS > 22) groups. Correlation and multivariable analyses were performed. RESULTS: A total of 149 STEMI patients (96 low SS, 53 mediate-high SS) were included. In terms of myocardial injury parameters, there was a positive correlation (p < 0.001, Spearman r = 0.292) between SS and infarct size (IS), and a negative correlation (p < 0.001, Spearman r = - 0.314) between SS and myocardial salvage index (MSI). In the multivariable model, SS (> 22 as categorical variable, OR = 2.245, 95% CI [1.002-5.053], p = 0.048; as continuous variable, OR = 1.053, 95% CI [1.014-1.095], p = 0.008) was significantly associated with high IS (≥ mean 35.43). The areas under the receiver operating characteristic (ROC) curves of SS for high IS and low MSI (≤ median 28.01) were 0.664 and 0.610. CONCLUSIONS: In STEMI patients undergoing primary PCI, SYNTAX score positively correlated with infarct size and negatively with myocardial salvage, indicating an independent predictive value of the myocardial injury.

Different Changing Patterns of Three NOS-NO System Activities after Ischemia-Reperfusion in Rabbit with AMI.

NOS-NO system activity is closely correlated with ischemia-reperfusion injury (IRI) and NOS subtypes were suggested to play different roles in IRI. In this work, the activity of serum NOS, NO levels, and ischemic necrosis after reperfusion in rabbit with AMI at different time was studied. We also explored the NOS-NO system activity changes and its correlation with myocardial ischemia and necrosis. It shows that after reperfusion in rabbits with AMI, NO-NOS system activities present different changes at each time point due to inactivation of NO and iNOS activation, and different experimental animals, ischemia-reperfusion degree, and length of time will also lead to different research results. Therefore, it is necessary to conduct dynamic observation on animals from different species at multi-temporal point under the state of NOS-NO system activities, and simultaneously detect inflammatory factor, MDA, and SOD indexes. Therefore, it is a must to conduct relevant drug research studies to make NOS-NO system activities maintain the level in favor of ideal myocardial ischemia reperfusion.

Establishment and validation of a risk model for prediction of in-hospital mortality in patients with acute ST-elevation myocardial infarction after primary PCI.

BACKGROUND: Currently, how to accurately determine the patient prognosis after a percutaneous coronary intervention (PCI) remains unclear and may vary among populations, hospitals, and datasets. The aim of this study was to establish a prediction model of in-hospital mortality risk after primary PCI in patients with acute ST-elevated myocardial infarction (STEMI). METHODS: This was a multicenter, observational study of patients with acute STEMI who underwent primary PCI. The outcome was in-hospital mortality. The least absolute shrinkage and selection operator (LASSO) method was used to select the features that were the most significantly associated with the outcome. A regression model was built using the selected variables to select the significant predictors of mortality. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to evaluate the performance of the nomogram. RESULTS: Totally, 1169 and 316 patients were enrolled in the training and validation sets, respectively. Fourteen predictors were identified by the LASSO analysis: sex, Killip classification, left main coronary artery disease (LMCAD), grading of thrombus, TIMI classification, slow flow, application of IABP, administration of ß-blocker, ACEI/ARB, symptom-to-door time (SDT), symptom-to-balloon time (SBT), syntax score, left ventricular ejection fraction (LVEF), and CK-MB peak. The mortality risk prediction nomogram achieved good discrimination for in-hospital mortality (training set: C-statistic = 0.987; model calibration: P = 0.722; validation set: C-statistic = 0.984, model calibration: P = 0.669). Area under the curve (AUC) values for the training and validation sets are 0.987 (95% CI: 0.981-0.994, P = 0.003) and 0.990 (95% CI: 0.987-0.998, P = 0.007), respectively. DCA shows that the nomogram can achieve good net benefit. CONCLUSIONS: A novel nomogram was developed and is a simple and accurate tool for predicting the risk of in-hospital mortality in patients with acute STEMI who underwent primary PCI.

Enhancing enzymatic hydrolysis of xylan by adding sodium lignosulfonate and long-chain fatty alcohols.

Sodium lignosulfonate (SXSL) and long-chain fatty alcohols (LFAs) could enhance the enzymatic hydrolysis of xylan, and the compound of SXSL and LFAs have synergies on the enzymatic hydrolysis. SXSL shows a strong enhancement in buffer pH range from 4.0 to 6.0. The enhancement increased with the SXSL dosage and the xylanase loading. The cellulose and lignin in corncob substrate could not only adsorb xylanase nonproductively, but also seriously reduce the accessibility of xylanase on xylan to impede the enzymatic hydrolysis of xylan. Cellulase could break the plant cell wall structure of corncob and make additives work better. The xylose yield of corncob at 72h increased from 59.4% to 73.7% by adding the compound of 5g/L SXSL and 0.01% (v/v) n-decanol, which was higher than that without cellulase and additives by 30.7%. Meanwhile, the glucose yield at 72h of corncob increased from 45.8% to 62.3%.

Impact of Anemia and Dual Antiplatelet Therapy on Mortality in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents.

The objective was to assess the impact of baseline anemia on all-cause mortality and whether 12-month dual antiplatelet therapy (DAPT) affects 1-year mortality linked to anemia in patients after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). 4109 enrolled patients divided into three groups based on their pre-procedural hemoglobin (Hb) level: Hb < 100 mg/L represented moderate-severe anemia; 100 mg/L ≤ Hb < 120 mg/L for women and 100 mg/L ≤ Hb < 130 mg/L for men represented mild anemia; Hb ≥ 20 mg/L for women and Hb ≥ 130 mg/L for men represented no anemia. DAPT medications were prescribed when patients were discharged. There were significant differences in 30-day and 1-year mortality between moderate-severe anemia and no anemia patients (HR 8.05, 95% CI 1.46 to 44.33, P = 0.017; HR 3.93, 95% CI 1.11 to 13.98, P = 0.034), and in long-term mortality between anemia and no anemia groups (HR 1.82, 95% CI 1.17 to 2.83, P = 0.008 for mild anemia; HR 3.19,95% CI 1.29 to 7.86, P = 0.012 for moderate-severe anemia). There was not significant interaction between 12-month DAPT and anemia on mortality in anemic patients (P for interaction > 0.05). Anemia shows association with increased all-cause mortality in patients undergoing PCI. Twelve-month DAPT does not show synergy with anemia to increase the risk of all-cause 1-year mortality in anemic patients after PCI.

[Therapeutic efficacy of oxymatrine on arrhythmia and heart rate variability in patients with coronary heart disease].

OBJECTIVE: To evaluate the therapeutic efficacy of oxymatrine (Oxy) on arrhythmia and heart rate variability (HRV) in patients with coronary heart disease (CHD) by Holter electrocardiogram and HRV indexes. METHODS: One hundred and ten patients with CHD and frequent arrhythmia were randomly divided into the Oxy group and the propafenone group, 55 cases in each group. Changes of general conditions, 48 hrs Holter electrocardiogram, frequency of premature beats, P-R interval, R-R interval and 24 hrs HRV index in patients before and after treatment were evaluated. RESULTS: The amount of both atrial and ventricular premature beats decreased markedly in both groups (P < 0.01). Propafenone showed better effect in reducing atrial premature beats than that of Oxy (P < 0.05), while the two had similar effect on ventricular premature beats (P > 0.05). HRV was elevated in both groups after treatment (P < 0.01), but the effect of Oxy was superior to that of propafenone after treatment (P < 0.05). CONCLUSION: Oxymatrine could significantly improve HRV, and shows obvious effects on atrial and ventricular arrhythmia in patients with CHD.

[Progress of cardiovascular pharmacologic study on berbamine].

Berbamine (molecular formular C37H40N2O6) is a bi-benzle-isoquinolyl alkaloid extracted from Berberis poiretil Schneid (genus of Berberis, family of Beridaceae), a kind of Chinese plants. In aspect of cardiovascular pharmacology, berbamine shows actions of anti-arrhythmia, anti-myocardial ischemia, vasodilatating to lower blood pressure, and antithrombosis, it could lower heart function and heart rate. Study on its anti-arrhythmia was the deepest one. The significant anti-arrhythmia action can be achieved by inhibiting ionic channels of sodium, potassium, calcium, etc., negative frequency and negative transduction, improving the diastolic excitation threshold of myocardium, prolonging effective refractory period of myocardium. As a direction of researches on new type of antiarrhythmic herbs and herbal drugs, the study on berbamine is worthy of further research and development.