RESUMO
Thrombotic disease is a serious threat to human health. The rapid and accurate detection of thrombosis is still a clinical challenge. To achieve the accurate diagnosis of thrombosis with magnetic resonance imaging (MRI), nanomaterials-based contrast agents have been developed in recent years. In this study, cyclic RGD functionalized liposomes targeted to the activated platelets are developed for thrombosis dual-mode MRI. The cyclic RGD functionalized liposomes (cRGD@MLP-Gd) encapsulated with gadolinium diethylenetriamine penta-acetic acid (Gd-DTPA) and superparamagnetic iron oxide (SPIO) are prepared, and their thrombus-targeted T1 and T2 MRI potential is evaluated in vitro and in vivo. Results show that cRGD@MLP-Gd could actively bind to the activated platelets and gradually accumulate at the thrombus site with a T1 - T2 contrast enhancement imaging effect in vitro. In in vivo MRI experiments, cRGD@MLP-Gd exhibits a T2 contrast enhancement at 1 h after intravenous administration, followed by a visibly larger T1 contrast enhancement at the thrombus site. This dynamic property showed that cRGD@MLP-Gd could actively bind to thrombus and possessed an enhanced T1 and T2 dual-mode MRI effect in vivo. Our results establish the characterization, feasibility and superiority of cRGD@MLP-Gd for the rapid identification of thrombosis, showing great potential to improve diagnostic accuracy and sensitivity to thrombosis of the MRI technique.
Assuntos
Plaquetas/efeitos dos fármacos , Imageamento por Ressonância Magnética , Peptídeos Cíclicos/farmacologia , Trombose/diagnóstico por imagem , Trombose/tratamento farmacológico , Animais , Cloretos , Compostos Férricos/química , Compostos Férricos/farmacologia , Gadolínio DTPA/química , Gadolínio DTPA/farmacologia , Lipossomos/química , Lipossomos/farmacologia , Masculino , Teste de Materiais , Peptídeos Cíclicos/química , Ratos , Ratos Sprague-Dawley , Trombose/induzido quimicamenteRESUMO
Previous studies have demonstrated that cholecystokinin octapeptide (CCK8) induces hypothermia and inhibits the systemic inflammatory response in septic shock in rat and murine models. The present study aimed to ascertain whether CCK8 induced hypothermia and improved the neurological outcomes in a porcine model of cardiopulmonary resuscitation (CPR). Ventricular fibrillation was induced and left untreated for 10 min in 12 male Bama miniature pigs. Defibrillation was attempted after 5 min of CPR. At 5 min following resuscitation, the pigs were randomized and equally assigned into the CCK8 or the control group. CCK8 was continuously infused for 1 h at a dose of 44.4 µg/kg/h and a rate of 20 ml/h in the CCK8 group. Body temperature, hemodynamic measurements and post-resuscitation myocardial function were monitored in the first 4 h following CPR. Neuron specific enzyme (NSE), S100B protein, tumor necrosis factor (TNF)-α and interleukin (IL)-6 were measured at baseline and 4, 12 and 24 h following resuscitation. The neurological deficient score (NDS) was recorded and cerebral samples were collected for terminal deoxynucleotidyl-transferase-mediated dUTP nick end labelling assay and integrated optical density (IOD) analysis at 24 h following CPR. The results revealed that hypothermia was not induced by CCK8; however, post-resuscitation NSE, S100B, IL-6 and TNF-α were significantly decreased, and NDS and IOD were significantly improved in the CCK8 group compared with the control group (P<0.05). The present study revealed that in a porcine model of CPR, CCK8 does not induce hypothermia, but inhibits the inflammatory response and significantly improves neurological outcomes.
RESUMO
BACKGROUND: Recently, very low concentrations of high-sensitivity cardiac troponin T (hs-cTnT), below the 99th percentile, have been used to immediately exclude acute myocardial infarction in certain patients without taking their age and sex into consideration. RESULTS: The hs-cTnT values below the 99th percentile (≤ 14 ng/L) were higher in men (p = 0.000) and significantly increased with age (p = 0.000) among both men and women. In addition, hs-cTnT was positively associated with age (r = 0.459, p = 0.000), myoglobin (r = 0.392, p = 0.000), and creatine kinase-MB (r = 0.133, p = 0.000). Moreover, males were younger (p = 0.001) and had higher myoglobin (p = 0.000) and creatine kinase-MB (p = 0.000) concentrations than females. MATERIALS AND METHODS: A total of 5585 consecutive subjects who presented with non-traumatic chest pain/discomfort to the inpatient, outpatient, or emergency department and who underwent high-sensitivity troponin T, myoglobin and creatine kinase-MB testing at presentation, with hs-cTnT below the 99thpercentile (≤ 14 ng/L), were eligible for enrollment. CONCLUSIONS: We suggest that patients' age, sex and levels of myocardial injury biomarkers should be taken into consideration when ruling out acute myocardial infarction and/or adverse prognostic implications in patients who have very low hs-cTnT concentrations.
RESUMO
AIMS: We evaluated the synergistic effect of lipoprotein-associated phospholipase A2 (Lp-PLA2) in association with classical risk factors in predicting coronary heart disease (CHD) and demonstrated the diagnostic value of Lp-PLA2 for predicting coronary stenotic lesions in subjects with CHD. METHODS: Blood samples were acquired from 911 consecutive adult subjects (662 males and 249 females) from 11 ethnic groups. Lp-PLA2 plasma levels were detected using a commercially available turbidimetric immunoassay (TIA). CHD in patients was confirmed using coronary angiography, and the severity of coronary atherosclerosis was assessed using the Gensini scoring system. RESULTS: A binary logistic regression was performed to analyse the relationships between Lp-PLA2 and other risk factors. A multivariate logistic regression analysis revealed that Lp-PLA2 levels were significantly associated with CHD (OR, 1.882; 95% CI, 1.369-2.587, p=0.000).The area under the receiver operating characteristic curve for Lp-PLA2 was 0.589 (95%CI, 0.549-0.629, p=0.000).The synergism between Lp-PLA2 and other risk factors was also investigated. The proportion of CHD attributable to the interaction between Lp-PLA2 and age was as high as 64%. CONCLUSIONS: Lp-PLA2 levels in human plasma were positively associated with the severity of CHD, and there was a clear positive interaction between Lp-PLA2 and classical risk factors in predicting CHD.
Assuntos
1-Alquil-2-acetilglicerofosfocolina Esterase/metabolismo , Doença das Coronárias/enzimologia , Etnicidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , China , Demografia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Curva ROC , Fatores de Risco , Estatísticas não ParamétricasRESUMO
BACKGROUND: Clopidogrel low response (CLR) is an independent risk factor of adverse outcomes in patients undergoing percutaneous coronary intervention (PCI), and intensified antiplatelet treatments (IAT) guided by platelet function assays might overcome laboratory CLR. However, whether IAT improves clinical outcomes is controversial. METHODS: Relevant trials were identified in PubMed, the Cochrane Library, and the Chinese Medical Journal Network databases from their establishment to September 9, 2014. Trials were screened using predefined inclusion criteria. Conventional meta-analysis and cumulative meta-analysis were performed using the Review Manager 5.0 and STATA 12.0 software programs. RESULTS: Thirteen randomized controlled trials involving 5111 patients with CLR were recruited. During a follow-up period of 1-12 months, the incidences of cardiovascular (CV) death, nonfatal myocardial infarction (MI), and stent thrombosis were significantly lower in the IAT arm than in the conventional antiplatelet treatment arm (relative risk [RR] = 0.45, 95% confidence interval [CI]: 0.36-0.57, P < 0.000,01), whereas bleeding was similar between the two arms (RR = 1.05, 95% CI: 0.86-1.27, P = 0.65). CONCLUSIONS: IAT guided by platelet function assays reduces the risk of CV death, nonfatal MI, and stent thrombosis (ST) without an increased risk of bleeding in patients undergoing PCI and with CLR.
Assuntos
Doenças Cardiovasculares/mortalidade , Inibidores da Agregação Plaquetária/uso terapêutico , Ticlopidina/análogos & derivados , Clopidogrel , Humanos , Infarto do Miocárdio/prevenção & controle , Intervenção Coronária Percutânea/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Stents/efeitos adversos , Ticlopidina/uso terapêuticoRESUMO
OBJECTIVE: This study was designed to examine the prevalence of unilateral and bilateral diagonal earlobe creases (DELCs) with respect to the diagnosis of coronary heart disease (CHD). METHODS: A total of 558 consecutive participants (402 males and 156 females) aged 36-91 years who underwent coronary angiography were enrolled in this study. The participants were classified as being without a DELC, having a unilateral DELC and having bilateral DELCs; participants with either a unilateral DELC or bilateral DELCs were defined as participants with DELCs. Significant CHD was defined as at least one major vessel with >50% stenosis, and coronary atherosclerosis severity was defined using the Gensini scoring system. RESULTS: In the present study, bilateral DELCs were more frequently among male (p=0.001), CHD (p=0.000), older people (p=0.000) and those with more severe coronary artery atherosclerosis (p=0.000). The results of the multiple regression analyses indicated that DELCs (OR, 4.861; 95% CI 3.093 to 7.642, p=0.000) remained independently associated with a risk of CHD. It was assumed that participants without a DELC have a certain background risk for CHD (OR is assumed to be 1); the results of the multivariate logistic regression indicated that the relative risk of CHD among participants with bilateral DELCs was 5.690 among all participants (OR, 5.690; 95% CI 3.450 to 9.384, p=0.000), 5.436 among male participants (OR, 5.436; 95% CI 2.808 to 10.523, p=0.000) and 7.148 among female participants (OR, 7.148; 95% CI 3.184 to 16.049, p=0.000). Moreover, a positive association between DELC and age (SI=1.21, SIM=1.65, AP =0.132), gender (SI=2.09, SIM=0.81, AP=0.49) and smoking status (SI=1.49, SIM=0.73, AP=0.29) was found, respectively. CONCLUSIONS: The results of the present study indicated that DELCs are a simple and a feasible means of identifying CHD. However, the exact mechanism underlying the relationship between DELCs and CHD warrants further study.
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Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Orelha Externa/anatomia & histologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Fatores SexuaisRESUMO
The aim of this study was to identify the synergistic effect of microRNA expression with classical risk factors of coronary heart disease (CHD) and to explore their diagnostic value for coronary stenotic lesions in subjects with CHD. Plasma samples were obtained from 66 subjects with CHD and from 58 control individuals. A quantitative reverse-transcription PCR (RT-qPCR) assay was conducted to confirm the relative expressions of the known CHD-related miRNAs. The severity of coronary atherosclerosis was based on the Gensini scoring system. The expression of miR-125b in plasma of the CHD group was lower than that of the non-CHD group (0.14 ± 0.09 vs. 0.18 ± 0.10, p = 0.055), and the miR-125b levels significantly decreased following an increasing Gensini score (P = 0.037). Spearman correlation analyses indicated the Gensini score was negatively associated with miR-125b (r = -0.215, p = 0.017). Of all the miRNAs, miR-125b showed the lowest AUC (0.405; 95% CI: 0.305 ~ 0.506, p = 0.070). We found several synergistic effects between miR-125b and classical risk factors, such as age, sex, CR, FBG and HDL-C; the proportion of CHD attributable to the interaction of miR-125b and age was as high as 80%. Therefore, miR-125b was shown to play an important role in individual's susceptibility to developing CHD.
Assuntos
Doença da Artéria Coronariana/genética , Doença das Coronárias/genética , Predisposição Genética para Doença , MicroRNAs/genética , Fatores Etários , Idoso , Área Sob a Curva , Glicemia/metabolismo , Estudos de Casos e Controles , HDL-Colesterol/sangue , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/patologia , Doença das Coronárias/sangue , Doença das Coronárias/diagnóstico , Doença das Coronárias/patologia , Creatinina/sangue , Jejum , Feminino , Regulação da Expressão Gênica , Humanos , Masculino , MicroRNAs/sangue , Pessoa de Meia-Idade , Estudos Prospectivos , Curva ROC , Fatores de Risco , Índice de Gravidade de Doença , Fatores SexuaisRESUMO
OBJECTIVE: The purpose of this study was to investigate the influence of weather on the occurrence of acute ST-elevation myocardial infarction in Chinese subjects. METHODS: Weather and climate data, as well as the occurrence of STEMI, were monitored at 2 am, 8 am, 2 pm, and 8 pm between 2003 and 2010. Generalized additive Poisson models were utilized to plot the numbers of patients with STEMI within 6 hour intervals against climatological variations, after accounting for the effects of the hour and season. RESULTS: The inclusion of meteorological conditions, including observed atmospheric pressure (hPa, hectopascal) variations during the previous three hours and temperature (°C, degrees Celsius), significantly affected the occurrence of STEMI, as measured every six hours. Compared with the 50th percentile of atmospheric pressure variations, the RRs (95% CI) for the first percentile, 10th percentile, 25th percentile, 75th percentile, 90th percentile, and 99th percentile of atmospheric pressure variation over lag 0 were 1.66 (1.36â¼2.03), 1.47 (1.30â¼1.67), 1.22 (1.12â¼1.33), 1.16 (1.07â¼1.25), 1.27 (1.13â¼1.43), and 1.16 (0.92â¼1.46), respectively. Compared to the 50th percentile of temperature, the RRs (95% CI) for the first percentile, 10th percentile, 25th percentile, 75th percentile, 90th percentile, and 99th percentile of temperature over lag 0 were 0.58 (0.40â¼0.83), 0.60 (0.46â¼0.78), 0.69 (0.57â¼0.83), 1.33 (1.14â¼1.56), 1.39 (1.13â¼1.71), and 1.17 (0.84â¼1.63), respectively. CONCLUSIONS: Based on the eight-year, single-center study, significant relationships were observed among the occurrence of STEMI and atmospheric pressure variations during the previous three hours and temperature after account for long-term time trends.
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Doença Aguda/epidemiologia , Dor no Peito/epidemiologia , Dor no Peito/fisiopatologia , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/fisiopatologia , Pressão Atmosférica , China , Humanos , Estudos Prospectivos , Estações do Ano , Temperatura , Fatores de Tempo , Tempo (Meteorologia)RESUMO
OBJECTIVE: to explore the impact of admission serum creatinine concentration on the in-hospital mortality and its interaction with age and gender in patients with acute ST-segment elevation myocardial infarction (STEMI) in China. METHODS: 1424 acute STEMI patients were enrolled in the study. Anthropometric and laboratory measurements were collected from every patient. A Cox proportional hazards regression model was used to determine the relationships between the admission serum creatinine level (Cr level), age, sex and the in-hospital mortality. A crossover analysis and a stratified analysis were used to determine the combined impact of Cr levels with age and gender. RESULTS: Female (HR 1.687, 95%CI 1.051 â¼ 2.708), elevated Cr level (HR 5.922, 95%CI 3.780 â¼ 9,279) and old age (1.692, 95%CI 1.402 â¼ 2.403) were associated with a high risk of death respectively. After adjusting for other confounders, the renal dysfunction was still independently associated with a higher risk of death (HR 2.48, 95% CI 1.32 â¼ 4.63), while female gender (HR 1.19, 95%CI 0.62 â¼ 2.29) and old age (HR 1.77, 95%CI 0.92 â¼ 3.37) was not. In addition, crossover analysis revealed synergistic effects between elevated Cr level and female gender (SI = 3.01, SIM = 2.10, AP = 0.55). Stratified analysis showed that the impact of renal dysfunction on in-hospital mortality was more pronounced in patients <60 years old (odds ratios 11.10, 95% CI 3.72 to 33.14) compared with patients 60 to 74 years old (odds ratios 5.18, 95% CI 2.48 â¼ 10.83) and patients ≥ 75 years old (odds ratios 3.99, 95% CI 1.89 to 8.42). CONCLUSION: Serum Cr concentration on admission was a strong predictor for in-hospital mortality among Chinese acute STEMI patients especially in the young and the female.
Assuntos
Creatinina/sangue , Infarto do Miocárdio/sangue , Infarto do Miocárdio/diagnóstico , Doença Aguda , Fatores Etários , Idoso , China/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/epidemiologia , Prognóstico , Modelos de Riscos Proporcionais , Fatores SexuaisRESUMO
OBJECTIVE: To develop a risk score by incorporating Hemoglobin A1c(HbA1c) with traditional risk factors for the prediction of coronary artery disease (CAD) in Chinese subjects. METHODS: A total of 196 consecutive subjects (131 males and 65 females) aged 38-89 years who underwent coronary angiography were enrolled in this study. HbA1c risk score sheets for the prediction of CAD were developed using age, gender and HbA1c. A receiver-operating characteristic curve analysis was used to determine the optimum cut-off levels of the HbA1c risk score for predicting CAD. RESULTS: In the ROC curve analysis, the optimal cut-off value of the HbA1c score for predicting CAD was 5.1, with a sensitivity of 72.0% and a specificity of 75.5% (area under the curve 0.781, 95% confidence interval 0.709 to 0.854, p=0.000). CONCLUSIONS: The HbA1c score system is a simple and feasible method that can be used for the prediction of CAD. Large-scale studies are needed to further substantiate these results.
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Angiografia Coronária , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Hemoglobinas Glicadas/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROCRESUMO
We performed a large, long-term cohort study to evaluate the association of renin-angiotensin-aldosterone system gene polymorphisms and baseline phenotypes to all-cause mortality among patients with angiographically confirmed coronary atherosclerosis. The study included 1075 subjects who underwent coronary angiography. Patients were genotyped for eight polymorphisms (rs4343, rs5186, rs5182, rs5049, rs5051, rs699, rs4762, and rs1799998), and their baseline plasma angiotensin II and aldosterone levels were measured. The interval between baseline and follow-up time-points ranged from 6.39 to 9.59 years. The results of multivariate regression analysis further indicated that high baseline angiotensin II levels (1.226 (1.024-1.468), p = 0.027) were independently associated with all-cause death. Therefore, we found that an increased baseline plasma angiotensin II level was associated with higher long-term all-cause mortality, even after correcting for established cardiovascular risk factors.
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Povo Asiático/genética , Doença da Artéria Coronariana/genética , Polimorfismo de Nucleotídeo Único , Sistema Renina-Angiotensina/genética , Idoso , Aldosterona/sangue , Alelos , Angiotensina II/sangue , China , Doença da Artéria Coronariana/mortalidade , Doença da Artéria Coronariana/patologia , Feminino , Seguimentos , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Modelos de Riscos Proporcionais , Análise de Regressão , Fatores de RiscoRESUMO
OBJECTIVE: To investigate the effect of the anti-platelet effect of aspirin plus clopidogrel on off-pump coronary artery bypass (OPCAB) grafting and the possible side effects of such therapy. METHODS: Sixty patients who underwent standard OPCAB were randomized immediately after surgery in two groups: the aspirin alone group of 30 patients who received aspirin (100 mg) daily; and the combination group of 30 patients who received clopidogrel (75 mg) plus aspirin (100 mg) daily. Platelet aggregation in response to arachidonic acid (PLAA) and adenosine diphosphate (PLADP) were measured at baseline (before surgery) and 1-6, 8, and 10 days after the medication. Postoperative bleeding and other perioperative parameters were compared between these two groups. RESULTS: There were no significant differences between the two groups in perioperative findings including average number of distal anastomosis, operative time, postoperative bleeding, ventilation time, and intensive care unit stay (all P>0.05). The proportion of patients with the PLAA above 20% value was significantly lower in the combination group than those in the aspirin alone group (32.1% vs 62.1%, P<0.05). PLAA of two groups one and two days after taking aspirin or plus clopidogrel were (24.2±31.9)% vs. (49.6±32.6)% and (13.8±27.2)% vs. (37.6±37.4)%, respectively (P<0.05). No obvious postoperative complication was noted in both groups. Multivariate analysis showed that clopidogrel administration was independently correlated with aspirin resistance (P=0.044, OR = 0.09;95% CI=0.07-0.48). CONCLUSION: Early combined use of aspirin plus clopidogrel after OPCAB can remarkably reduce OPCAB-related aspirin resistance and enjoy similar safety.
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Aspirina/uso terapêutico , Doença das Coronárias/dietoterapia , Inibidores da Agregação Plaquetária/uso terapêutico , Ticlopidina/análogos & derivados , Idoso , Clopidogrel , Ponte de Artéria Coronária sem Circulação Extracorpórea , Doença das Coronárias/cirurgia , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Ticlopidina/uso terapêuticoRESUMO
Slight elevations in cardiac troponin I and T are frequently observed after percutaneous coronary intervention (PCI). Contrast-induced acute kidney injury (CI-AKI) is a complex syndrome induced by exposure to intravascular contrast media (CM). Currently, the relationships between the CM, pre-existing kidney insufficiency, CI-AKI, and myonecrosis after elective PCI are unclear. To investigate the relationship between CI-AKI and post-procedural myonecrosis (PMN) after PCI, we analyzed 327 non-ST-segment elevation acute coronary syndrome subjects undertaking elective PCI. The levels of cardiac troponins (cTns), cTnI and cTnT, at baseline and on at least one occasion 18-24 h after PCI were measured. We also recorded serum levels of creatinine (SCr) and the urine albumin:creatinine ratio (ACR) before coronary angiography, and 24-48 h and 48-72 h after contrast administration. A post-procedure increase in cTns was detected in 16.21% (53/327) of subjects with cTns levels >99th to 5×99th percentile upper reference limit (URL). Twenty-seven patients (8.26%) developed CI-AKI. CI-AKI occurred more often in subjects with PMN than in those without PMN (20.8% versus 5.8%, respectively, P=0.001). Multiple logistic regression analysis revealed that pre-existing microalbuminuria (MA) was an important independent predictor of PMN (OR: 3.31; 95% CI: 1.26-8.65, P=0.01). However, there was no correlation between the incidence of CI-AKI and PMN (OR: 2.38; 95% CI: 0.88-6.46, P=0.09). We conclude that pre-existing MA was not only an important independent predictor of CI-AKI but also of PMN.
Assuntos
Injúria Renal Aguda/etiologia , Miocárdio/patologia , Intervenção Coronária Percutânea/efeitos adversos , Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/complicações , Síndrome Coronariana Aguda/terapia , Injúria Renal Aguda/sangue , Injúria Renal Aguda/fisiopatologia , Idoso , Albuminúria/complicações , Meios de Contraste/efeitos adversos , Creatinina/sangue , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Necrose , Estudos Prospectivos , Fatores de Risco , Troponina I/sangue , Troponina T/sangueRESUMO
OBJECTIVE: To evaluate the feasibility, efficacy and safety of the percutaneous coronary intervention (PCI)guided by computed tomography (CT) coronary angiography derived roadmap and magnetic navigation system (MNS). METHODS: During June 2011 and May 2012, thirty consecutive patients receiving elective PCI were enrolled, coronary artery disease was primarily diagnosed by dual-source CT coronary angiography (DSCT-CA) at outpatient clinic and successively proved by coronary artery angiography in the hospital. Target vessels from pre-procedure DSCT-CA were transferred to the magnetic navigation system, and consequently edited, reconstructed, and projected onto the live fluoroscopic screen as roadmap. Parameters including characters of the target lesions, time, contrast volume, radiation dosage for guidewire crossing, and complications of the procedure were recorded. RESULTS: Thirty patients with 36 lesions were recruited and intervened by PCI. Among the target lesions, sixteen were classified as type A, 11 as type B1, 8 as type B2, 1 as type C. The average length of the target lesions was (22.0 ± 9.8) mm, and the average stenosis of the target lesions was (81.3 ± 10.3)%. Under the guidance of CT roadmap and MNS, 36 target lesions were crossed by the magnetic guidewires, with a lesion crossing ratio of 100%. The time of placement of the magnetic guidewires was 92.5 (56.6 - 131.3) seconds. The contrast volume and the radiation dosage for guidewire placement were 0.0 (0.0 - 3.0) ml and 235.0 (123.5 - 395.1) µGym(2)/36.5 (21.3 - 67.8) mGy, respectively. Guidewires were successfully placed in 21 (58.3%) lesions without contrast agent. All enrolled vessels were successfully treated, and there were no MNS associated complications. CONCLUSIONS: It is feasible, effective and safe to initiate PCI under the guidance of CT derived roadmap and MNS. This method might be helpful for the guidewire placement in the treatment of total occlusions.
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Angiografia Coronária/métodos , Intervenção Coronária Percutânea , Tomografia Computadorizada por Raios X , Idoso , Feminino , Humanos , Magnetismo , Masculino , Pessoa de Meia-IdadeRESUMO
AIMS: To explore the association between six single-nucleotide polymorphisms in OLR1, PON1, MTHFR gene and the angiographical characteristics of coronary atherosclerosis to determine if any of the conventional factors correlate with genetic polymorphisms in the advent of the disease. METHODS: We examined rs1801131, rs1801133, rs3736232, rs3736234, rs854563 and rs662 by TaqMan® SNP Genotyping Assays in 1075 subjects that underwent angiography. The angiographical characteristics of coronary atherosclerosis were defined by the Gensini Score system. RESULTS: The T allele of rs1801133 was associated with coronary atherosclerosis severity with the OR = 1.49, 95% CI = 1.04-2.14. In MTHFR gene, haplotype T-A was a susceptibility haplotype to coronary atherosclerosis (OR = 1.27, 95% CI = 1.06-1.51) whereas haplotype C-A had a protective effect (OR = 0.83, 95% CI = 0.70-0.99). In addition, several synergistic effects between rs1801133 and conventional risk factors such as diabetes and smoking were found. CONCLUSIONS: Collectively, the results demonstrate that the T allele of rs1801133 conferred an increased risk for coronary atherosclerosis. The MTHFR C-A haplotype was a protective haplotype, while T-A haplotype was a susceptibility haplotype. The presence of the T allele of rs1801133 increases the odds of coronary atherosclerosis severity when associated with conventional risk factors.
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Arildialquilfosfatase/genética , Povo Asiático/genética , Doença da Artéria Coronariana/genética , Polimorfismo de Nucleotídeo Único , Receptores Depuradores Classe E/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , China , Feminino , Genótipo , Haplótipos , Humanos , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , FumarRESUMO
OBJECTIVE: To explore the association between rs6903956 and severity of coronary artery disease (CAD) in a Chinese population. METHODS: A cohort of 1075 consecutive patients who underwent coronary arteriography for suspected or known coronary atherosclerosis was enrolled in our study. Coronary atherosclerosis severity was defined by Gensini's Score System and counts of diseased vessels. RESULTS: Gensini score frequencies and counts of diseased vessels differed among GG, AG, AA genotype groups at the rs6903956 locus (p = 0.025 for Gensini score frequencies vs. p = 0.024 for counts of diseased vessels, respectively). A univariate logistic regression analysis revealed that the genotype distribution of this SNP was associated significantly with angiographical characteristics of coronary atherosclerosis risk (p = 0.030, odds ratio (OR) = 1.444, 95% confidence interval (CI) = 1.036â¼2.013 for AG vs. GG; p = 0.021, OR = 5.896, 95% CI = 1.299â¼26.750 for AA vs. GG and p = 0.007, OR = 1.564, 95% CI = 1.132â¼2.162 for combined (AG+AA) vs. GG). A multivariate logistic regression analysis indicated that the genotype distribution of the rs6903956 polymorphism be associated significantly with the angiographical characteristics of coronary atherosclerosis risk (p = 0.004, OR = 1.578, 95% CI = 1.155â¼2.154 for GG vs. AG vs. AA; p = 0.013, OR = 1.541, 95% CI = 1.097â¼2.163 for GG vs. GA+ AA). A stratification analysis revealed that male subjects and smoking subjects had a higher frequency of the rs6903956 heterozygous mutant among higher Gensini score subjects than among lower Gensini score subjects (p = 0.023, OR = 1.579, 95% CI = 1.064â¼2.344 for male subgroup; p = 0.005, OR = 2.075, 95% CI = 1.249â¼3.448 for smoking subgroup). CONCLUSIONS: Allele A is a risk factor for CAD and the G-to-A allele substitution may underlie the association between rs6903956 and CAD.
Assuntos
Povo Asiático/genética , Cromossomos Humanos Par 6/genética , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/genética , Polimorfismo de Nucleotídeo Único , Idoso , Estudos de Coortes , Feminino , Loci Gênicos/genética , Predisposição Genética para Doença/genética , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The benefits of the magnetic navigation system (MNS) for percutaneous coronary intervention (PCI) remain unclear, and a comparison of the MNS assisted approach to the conventional approach for PCI, when used in daily practice, is little studied. This study aimed to investigate the benefits of an MNS assisted technique as compared to the conventional technique for PCI. METHODS: Forty-eight consecutive patients scheduled for PCI were recruited between December 2009 and April 2010. MNS assisted PCIs were performed on 54 target vessels. Another 45 patients with 54 target vessels undergoing conventional PCIs were selected from a historical population of patients to match the MNS group according to the coronary lesion type (ACC/AHA classification). Emergency PCIs and chronic total occlusions were excluded from both groups. Analyses were performed using Stata 9.2 statistical software. RESULTS: There were no significant differences between the baseline characteristics of the MNS group and the control group. The success rates were 100.0% for the MNS assisted PCI and 98.1% for the conventional PCI, which did not reach a significant difference (P = 1.000); there were also no significant differences in terms of guide wire crossing time ((51.7 ± 30.5) seconds vs. (57.5 ± 49.4) seconds, P = 0.448), operation time ((28.4 ± 15.9) minutes vs. (28.0 ± 24.7) minutes, P = 0.935), X-ray exposure ((458.1 ± 350.1) µGym(2) vs. (558.7 ± 451.7) µGym(2), P = 0.197; and (94.2 ± 80.9) mGy vs. (96.2 ± 77.3) mGy, P = 0.895) or contrast usage ((7.3 ± 4.0) ml vs. (6.1 ± 3.7) ml, P = 0.121) between the two groups. However, a trend toward shorter guide wire crossing time and less X-ray exposure were observed for the magnetic group. CONCLUSION: In daily practice, MNS assisted PCI resulted in a similar procedural success rate, operation time, and contrast usage, with a trend toward shorter guide wire crossing time and less X-ray exposure when compared to the conventional PCI.
Assuntos
Angioplastia Coronária com Balão/métodos , Doença da Artéria Coronariana/terapia , Magnetismo/instrumentação , Idoso , Angioplastia Coronária com Balão/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Maize roots release a battery of proteins into the rhizosphere during growth and development. In the present study, mucilage secreted by primary roots of 3-4 d old maize seedlings was collected under axenic conditions, and the constitutively secreted proteins were analyzed by different methods, including two-dimensional electrophoresis--MADLI-TOF, LC-MS, and Shotgun techniques. The results showed that 200 protein spots could be observed on two-dimensional electrophoresis gel stained by silver nitrate. However, due to the low protein content for each protein spot, there was not reliable result after identification by MADLI-TOF. On the other hand, 152 and 2848 proteins were identified by LC/MS and Shotgun technique, respectively. All 152 proteins identified by LC/MS method could be found in the proteins identified by Shotgun method, and thus the results obtained by LC/MS and Shotgun method could be authenticated mutually. The results demonstrated that the Shotgun method is more sensitive than the other methods for protein identification, especially for the proteins with lower contents and complex interfering substances, such as the plant root released proteins.