RESUMO
Cardiovascular diseases (CVDs) remain the leading cause of death worldwide, while coronary artery disease (CAD) account for a large part of CVDs. Vascular CXCR4 could limit atherosclerosis by maintaining arterial integrity. Here, we conducted a population-based, case-control study to evaluate the associations of common genetic variation within the CXCR4 gene (rs2228014, rs117600832, rs2471859, and rs2322864) with CAD risk in a Chinese population. We found that CXCR4 rs2228014 was significantly associated with 1.29-fold increased risk of CAD (A vs G: OR = 1.29; 95% CI = 1.07-1.55; P = 0.007). The subjects with genotype AA (OR = 1.98; 95% CI = 1.03-3.81; P = 0.041) and AG (OR = 1.27; 95% CI = 1.02-1.58; P = 0.030) have higher risk of CAD, compared with those with genotype GG. Furthermore, both in the CAD patients with diabetes and those without diabetes, rs2228014 was significantly associated with increased risk of CAD (P < 0.05). Additionally, we also validated the significant association for rs2322864 (C vs T: OR = 1.20; 95% CI = 1.00-1.44; P = 0.046). Knockout of CXCR4 gene could significantly impair the capacity of cholesterol efflux (P < 0.01). These findings strongly suggest that CXCR4 polymorphisms might contribute to CAD susceptibility, and the exact biological mechanism awaits further research.
RESUMO
Objective To investigate the efficacy and safety of 6-month and 12-month oral dual-antiplatelet therapy This work was supported by the National Key Technology Research and Development Program in the Twelfth Five-year Plan of China (2011BAIl1B07) and the Military Clinical Key Technology and Development Program (2010gxjs001)(DAPT) on patients implanted with biodegradable polymer-coated and drug-eluted long stents (BP-DES).Methods In the I-LOVE-IT 2 trial,574 patients implanted with biodegradable polymer-coated and sirolimus-eluted long stent (BP-SES) (total stent length ≥50mm) were randomized to accepting either 6-month (n=270) or 12-month (n=304) DAPT.The primary endpoint of present study was 12-month target lesion failure (TLF),including cardiac death,target vessel myocardial infarction and clinically indicated target lesion revascularization (CI-TLR).The major secondary endpoint was 12-month net adverse clinical events (NACE),including all-causes of death,myocardial infarction,stroke,all revascularization (CI-TLR plus clinically indicated nontarget lesion revascularization) and bleeding.Results For the patients implanted with BP-SES of total stent length≥ 50mm,the total stent length was 73.0 ± 22.5mm and 69.8 ± 19.4mm in the 6-month DAPT group and 12-month group,respectively (P=0.07).No significant difference existed in the incidence of 12-month TLF between 6-month DAPT group and 12-month DAPT group (11.1％ vs.9.2％,P=0.47).The incidence of NACE was similar between the 2 groups (21.9％ vs.19.7％,P=0.57).The incidence of revascularization was lower in 12-month DAPT group (5.6％) than in 6-month DAPT group (11.1％,P=0.01).Furthermore,6-month landmark analysis showed that 12-month DAPT was associated with significantly lower risk of TLF (2.6％ vs.6.3％,P=0.03) at a cost of slightly increased risk of all bleeding events (1.6％ vs.0.7％,Log-rank P=0.32) between 6 and 12-months compared to 6-month DAPT.Conclusions In patients treated with BP-SES of total stent length ≥ 50mm,12-month DAPT have similar impacts on 12-month clinical outcomes except for all revascularization.However,12 months DAPT decreased the incidence of TLF and total revascularization between 6 months to 12 months after PCI.
RESUMO
Objective To study the protective effects of crocetin on myocardial ischemia-reperfusion injury, and their correlation with the signaling pathway of serine/threonine protein kinase (Akt)/glycogen synthase kinase (GSK)-3β/nitric ox?ide synthase (eNOS). Methods Forty healthy SD rats were divided into normal group (N), ischemia reperfusion group (IR) and 5, 10 and 15 mg/L of crocetin groups (CRO1, CRO2 and CRO3) by random number table method. The values of heart rate (HR), coronary flow (CF) and left ventricular pressure measurement (LVDP, LV+dp/dtmax, LV-dp/dtmax) 30 minutes after reperfusion were compared between five groups. TTC staining was used to detect the infarct volume. Spectrophotometric method was used to determinate the expression of lactate dehydrogenase (LDH) and creatine kinase (CK-MB). The levels of Akt, the phosphorylation of Akt (p-Akt), GSK-3β, phosphorylation of GSK-3β(p-GSK-3β), eNOS and phosphorylation of eNOS (p-NOS) were detected by Western blot assay. Results The HR, CF, LVDP, LV+dp/dtmax and LV-dp/dtmax were significantly lower 30 min after reperfusion in IR group than those of N group and crocetin groups (P<0.05). The myocardial infarction area was bigger in IR group than that of crocetin groups. The expression levels of LDH and CK-MB were signifi?cantly higher in IR group than those of N group and crocetin groups (P<0.05). The reperfusion index was higher in CRO3 group than that of CRO1 group. The infarction area, LDH and CK-MB expressions were significantly decreased in CRO3 group than those of CRO1 group (P<0.05). There were no significant differences in expressions of Akt, GSK-3βand eNOS between IR group, N group and crocetin groups. But p-Akt, p-GSK-3βand p-NOS were significantly decreased in IR group than those of N group and crocetin groups. The p-Akt, p-GSK-3βand p-NOS were significantly increased in CRO3 group than those of CRO1 group (P<0.05).Conclusion Crocetin has protective effects on myocrdial ischemia reperfusion injury in rats, which may be involved in the enhancing the phosphorylation of signalling pathway of Akt/GSK-3β/eNOS.
RESUMO
Objective To predict the infarction of related artery(IRA)and the site of occlusion by analyzing the diversify of electrocardiographic ST segment and coronary angiography findings in acute inferior myocardial infarction. Methods Sixty-four patients with acute inferior myocardial infarction were divided into two groups by coronary angiography: right coronary artery(RCA)occlusion group(51 patients)and left circumflex coronary artery(LCX)occlusion group(13 patients). RCA occlusion group included proximal,middle and distal components occlusion, and LCX occlusion group included proximal and distal components occlusion. The cases of STⅢ elevation ＞ ST Ⅱ ,STaVL depression ＞ STⅠ ,STV1 depression,STV7-V9 and STV3R-V5R elevation were recorded and compared. Results The percentage of STⅢ elevation ＞ STⅡ, STaVL depression ＞STⅠ, STV1 no depression, STV7-V9 no elevation and STV3R-V5R elevation was significantly higher in RCA occlusion group than those in LCX occlusion group(P ＜ 0.01 or ＜ 0.05). The percentage of ST Ⅲ elevation ≤ ST Ⅱ, ST,VL depression ≤STⅠ ,STV1 depression,STV7-V9 elevation,STV3R-V5R no elevation was significantly higher in LCX occlusion group than those in RCA occlusion group(P ＜0.01 or ＜0.05). In RCA occlusion group:the sensitivity of STⅢ elevation ＞ STⅡ, STaVL depression ＞ STⅠ and STV1 no depression was 90.2%, 80.4% and 80.4%;the specificity of STⅢ elevation ＞ STⅢ and STaVL depression ＞ STⅠwas 84.6% and 84.6% ;the sensitivity of STV3R-V5R elevation was 51.0%, but its specificity was 100.0%. In LCX occlusion group: the sensitivity of STⅢ elevation ≤ ST Ⅲ and STaVL depression ≤ ST Ⅰ was 84.6% and 84.6%, and their specificity was 90.2% and 80.4%;the specificity of STV1 depression and STV7-V9 elevation was 80.4% and 78.4%; the sensitivity of STV3R-V5R no elevation was 100.0% ,and its specificity was 51.0%. In RCA occlusion group, the percentage of STV3R-V5Relevation was higher in proximal components occlusion than that in distal components occlusion[76.9%(10/13)vs. 27.3%(3/11),P=0.015]. Conclusions The IRA can be initially judged by analysis of the characteristics in the ST segment in Ⅰ,Ⅱ ,Ⅲ ,aVL,V1,V7-V9,V3R-V5R lead in acute inferior myocardial infarction. And the ST segment elevation in V3R-V5R is meaningful in the judgment of proximal and distal components occlusion in RCA.
RESUMO
OBJECTIVE:To explore mechanism,prevention and treatment of thrombosis following implantation of coronary artery stent.METHODS:The first author used computer to retrieve Vip Database (http://www.cqvip.com/) for articles concerning thrombosis following implantation of coronary artery stent published from January 2000 to October 2009.The key words included "coronary artery,stent implantation,thrombus".The data were primarily screened,and references of each article were checked.Inclusion criteria:mechanism and risk factor of thrombosis in stent;prevention and treatment of thrombosis in stent.Exclusion criteria:articles addressing duplicated or old contents.Finally,28 articles were included.RESULTS:Thrombosis in stent was a severe complication in interventional therapy of coronary artery disease,could induce severe outcomes for the body.Compared with common mental stent,drug eluting stents can significantly reduce restenosis rate and revascularization rate of target lesions.Following stent implantation,thrombosis in stent can occur in early,late and extremely late phases.The mechanisms are different.Antiplatelet,anticoagulation and lipid-lowering therapy can diminish the occurrence rate of thrombosis in stent.Individual surgery and individual drug therapy not only can solve revascularization in the coronary artery,but also decrease restenosis rate and occurrence rate of thrombosis in stent.CONCLUSION:With the expectation of novel stents,various risk factors for thrombosis in stent should be assessed in detail to achieve individual surgery and individual drug therapy.During revascularization in the coronary artery,restenosis rate and occurrence rate of thrombosis in stent should be reduced.
RESUMO
Objective To observe the protective effect of magnesium gluconate on myocardial apoptosis by ischemia reperfusion injury in isolated rat hearts, and study the possible mechanism. Methods The hearts of 48 Sprague-Dawely rats were isolated, linked to Lange-ndorff perfusion apparatus, and randomly divided into 3 equal groups(n = 16 each) : Control group, ischemia/reperfusion (I/R) group and magnesium gheonate group. 8 rats in each group were perfused. Control group was pedused with modified KH buffer for 110min. I/B group was perfuesd with modified KH buffer for 20 min, then exposed to iscbemia for 30 min, and then reperfused with modified KH buffer for 60 min. Magnesium gheonate group was perfumed with modified KH buffer with magnesium gluconate for 20 min, then exposed to isohemia for 30 min and then reperfused with modified KH buffer with magnesium glueonate for 60 min. Lacate dehydrogenase (LDH) and ereatine kinase (CK) in the effluent liquid from the heart were measured after reperfusion. The concentration of Ca2+ and NO in the left ventricle were determined. The other 8 rats in each group were reperfused for 120 minutes as the method described before. After repeffusion, the myoeyte apoptosis was examined by Annexin-V-FITC/PI. After the two experiments the incidence of ventrieular arrhytlunias during reperfusion was assessed. Results Compared with I/R, magnesium glueonate decreased the incidence of ventricular an'hythmias(P <0. 01). The contents of CK and LDH in the effluent liquid from the heart in magnesium glueonate group was lower than that of I/R group (P <0. 01). The contents of Ca2+ and NO in the left ventricle in magnesium gluconate group was decreased than that of I/R group (P <0. 01). The index of myocyte apoptosis were significanfly lower in magnesium glueonate group than that of I/R group (apoptosis index :27.79±1.59 vs 33.61±2.10, P < 0. 01) . Conclusion Magnesium glueonate has protective effect on myocardial isohemia reperfusion injury in rats. The protective effect may be related to decreasing myocyte apoptosis by increasing the content of NO and relieving calcium overload.
RESUMO
Objective To report the experience of using R 0 Swartz sheath in patients with tortuous and prolonged aorta. Methods The radiofrequency ablation procedure could not be done in 4 patients (3 patients with left side accessory pathway, and 1 with idiopathic left ventricular tachycardia) because the ablation catheter could not be put in left ventricle due to tortuous and prolonged aorta. We tried to use R 0 Swartz sheath in these patients in order to put the catheter into left ventricle via small curve of the R 0 Swartz.Results The ablation procedures were successful in these 4 patients by using R 0 Swartz.Conclusion Using R 0 Swartz sheath in patients with tortuous and prolonged aorta is helpful in making the left side ablation procedure successful.
