In-hospital and 1-Year Outcomes of Repeated Percutaneous Coronary Intervention for In-stent Restenosis With Acute Coronary Syndrome Presentation.

BACKGROUND: In-stent restenosis (ISR) is the Achilles' heel of percutaneous coronary intervention (PCI). There have been controversial data about outcomes of repeated PCI (redo-PCI) for ISR. This study aims to determine the predictors of major adverse cardiac events (MACE) in patients underwent redo-PCI for ISR. METHODS: In this retrospective study, all patients with acute coronary syndrome who were underwent successful PCI for ISR at Tehran Herat Center (between 2004 and 2019) were eligible for inclusion. Patients with moderate to severe valvular heart disease and/or hematological disorders were excluded. Participants were divided into 2 groups based on the occurrence of the MACE [composite of cardiovascular death, myocardial infarction (MI), coronary artery bypass grafting, target vessel revascularization, and target lesion revascularization]; then, the study variables were compared between the 2 groups. Finally, the predictors of MACE were identified using Cox regression analysis. RESULTS: Of 748 redo-PCI patients (mean age: 65.2 ± 10.1; 71.0% males), 631 patients had met the inclusion criteria. Fifty-four patients (9.8%) developed MACE within a 1-year follow-up period. Multivessel disease, primary PCI, Ad-hoc PCI, history of non-ST-segment elevation MI, and diabetes mellitus were independent predictors for MACE. In a subgroup analysis, 30 patients who experienced third PCI (target lesion revascularization/target vessel revascularization) were followed more as 1-year MACE. Among these patients, 14 MACEs were observed during the last follow-up (till June 2020). CONCLUSIONS: Multivessel disease, primary PCI, and history of non-ST-segment elevation MI were the predictors of higher 1-year MACE, whereas Ad-hoc PCI and diabetes mellitus had a protective effect on MACE.

The effect of Achillea millefolium extract on spermatogenesis of male Wistar rats.

Achillea millefolium or yarrow, a native plant in many countries, has been recognized in historical medicine, mainly because of its astringent effects. However, some aspects of the toxicity of yarrow such as possible effects on male reproductive system are not well established. In this investigation, the effects of A. millefolium L. extract on spermatogenesis in adult male wistar rats were studied. Eighty-five male Wistar rats were divided into nine experimental groups (10 in each group except the ninth group). Extract was administered at the dose of 200, 400 and 800 mg/kg/day by intraperitoneal (IP) injection or through gavage for 22 days, on every other day. Three groups were determined as sham and control groups. Five rats from each group were killed and the rest of the rats were kept for 40 days later, but with no injection, to assess the reversibility of extract effect on spermatogenesis. The results of the study showed scattered immature cells on basal membrane in seminiferous tubules at the dose of 400 mg/kg/day IP. Moreover, a significant decrease in cell accumulation and vacuolization in seminiferous tubule was seen. At the dose of 800 mg/kg, IP, thickened seminiferous tubules on basal membrane, decrease in cell accumulation in seminiferous tubule, severe disarrangement, degenerative cells and severe decrease in sperm count were seen. At the dose of 800 mg/kg/day, orally, basal membrane was thickened and the disarrangement in cells was demonstrated. As a conclusion, our results suggest that the total extract of A. millefolium L. exhibit temporary antifertile activity in adult male animals.