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Regen Med ; 2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31829095


Aim: To determine the efficacy and safety of intracoronary infusion of autologous bone marrow mesenchymal stem cells (MSCINJ) in combination with intensive atorvastatin (ATV) treatment for patients with anterior ST-segment elevation myocardial infarction-elevation myocardial infarction. Patients & methods: The trial enrolls a total of 100 patients with anterior ST-elevation myocardial infarction. The subjects are randomly assigned (1:1:1:1) to receive routine ATV (20 mg/d) with placebo or MSCsINJ and intensive ATV (80 mg/d) with placebo or MSCsINJ. The primary end point is the absolute change of left ventricular ejection fraction within 12 months. The secondary end points include parameters in cardiac function, remodeling and regeneration, quality of life, biomarkers and clinical outcomes. Results & conclusion: The trial will implicate the essential of cardiac micro-environment improvement ('fertilizing') for cell-based therapy. Clinical Trial Registration: NCT03047772.

Am Heart J ; 196: 65-73, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29421016


BACKGROUND: Comparing with conservative strategy, early invasive approach has been shown to be beneficial for initially stabilized patients with non-ST-elevation myocardial infarction (NSTEMI). However, concerns of increased risk of bleeding and other complications associated with early revascularization in patients aged ≥75 years persist. A routinely deferred invasive strategy aiming to facilitate revascularization after stabilizing the culprit lesion predominates across China. AIM: The aim was to compare efficacy and safety of deferred invasive strategy versus guideline-recommended early invasive strategy in initially stabilized Chinese patients aged ≥75 years with NSTEMI. METHODS: Twenty qualified centers from 10 different provinces throughout mainland China will contribute to the study. Eligible patients will be central randomized to a routine deferred invasive approach or an early invasive approach (coronary angiography >72 hours or <24 hours of admission and appropriate revascularization). Patients meeting the inclusion criteria but not randomized for any reason will be registered. The primary end point of the present study is a composite of all-cause mortality, nonlethal (re) MI, ischemic stroke, and urgent revascularization at 1 year. Noninferiority design is used, and the inferiority margin was set to be 5%. The goal is to enroll 696 patients with expected primary end point rates of 30%, 2-tailed α of .05, power of 80%, and dropout rate of 5%. CONCLUSIONS: The DEAR-OLD trial is a prospective, nationwide, multicenter, noninferiority-designed, open-label randomized clinical trial evaluating efficacy and safety of routinely deferred invasive strategy compared with early invasive strategy in Chinese elderly patients with NSTEMI.

Tratamento Conservador/métodos , Revascularização Miocárdica/métodos , Infarto do Miocárdio sem Supradesnível do Segmento ST/mortalidade , Infarto do Miocárdio sem Supradesnível do Segmento ST/terapia , Tempo para o Tratamento , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , China , Angiografia Coronária/métodos , Eletrocardiografia/métodos , Feminino , Avaliação Geriátrica , Humanos , Masculino , Revascularização Miocárdica/efeitos adversos , Infarto do Miocárdio sem Supradesnível do Segmento ST/diagnóstico por imagem , Segurança do Paciente , Seleção de Pacientes , Prognóstico , Estudos Prospectivos , Medição de Risco , Resultado do Tratamento
BMC Cardiovasc Disord ; 14: 83, 2014 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-25022285


BACKGROUND: Statin therapy has shown to deplete atherosclerotic plaque lipid content and induce plaque regression. However, how early the plaque lipid depletion can occur with low-density lipoprotein cholesterol (LDL-C) lowering in humans in vivo has not been fully described. METHODS: We enrolled 43 lipid treatment naïve subjects with asymptomatic carotid atherosclerosis and LDL-C ≥ 100 and ≤ 250 mg/dl. Rosuvastatin 5-20 mg/day was used to lower LDL-C levels to < 80 mg/dl. Lipid profile and carotid MRI scans were obtained at baseline, 3, 12, and 24 months. Carotid plaque lipid-rich necrotic core (LRNC) and plaque burden were measured and compared between baseline and during treatment. RESULTS: Among the 32 subjects who completed the study, at 3 months, an average dose of rosuvastatin of 11 mg/day lowered LDL-C levels by 47% (125.2 ± 24.4 mg/dl vs. 66.7 ± 17.3 mg/dl, p < 0.001). There were no statistically significant changes in total wall volume, percent wall volume or lumen volume. However, LRNC volume was significantly decreased by 7.9 mm3, a reduction of 7.3% (111.5 ± 104.2 mm3 vs. 103.6 ± 95.8 mm3, p = 0.044). Similarly, % LRNC was also significantly decreased from 18.9 ± 11.9% to 17.9 ± 11.5% (p = 0.02) at 3 months. Both LRNC volume and % LRNC continued to decrease moderately at 12 and 24 months, although this trend was not significant. CONCLUSIONS: Among a small number of lipid treatment naïve subjects, rosuvastatin therapy may induce a rapid and lasting decrease in carotid plaque lipid content as assessed by MRI. TRIAL REGISTRATION: ClinicalTrials.Gov numbers NCT00885872.

Doenças das Artérias Carótidas/tratamento farmacológico , Artéria Carótida Primitiva/efeitos dos fármacos , LDL-Colesterol/sangue , Fluorbenzenos/uso terapêutico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Imagem por Ressonância Magnética , Placa Aterosclerótica , Pirimidinas/uso terapêutico , Sulfonamidas/uso terapêutico , Idoso , Doenças Assintomáticas , Biomarcadores/sangue , Doenças das Artérias Carótidas/sangue , Doenças das Artérias Carótidas/diagnóstico , Artéria Carótida Primitiva/metabolismo , Artéria Carótida Primitiva/patologia , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , Valor Preditivo dos Testes , Estudos Prospectivos , Rosuvastatina Cálcica , Fatores de Tempo , Resultado do Tratamento
Thromb Res ; 131(3): 218-24, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23340097


BACKGROUND: Chronic kidney disease (CKD) is an established predictor of recurrent ischemic events in patients with coronary artery disease (CAD). This association has been partially ascribed to high post-treatment platelet reactivity (HPPR) according to platelet function testing. However, the influencing factors of HPPR are assay-dependent, and the relevant data of elderly patients with stable CAD are absent. PATIENTS AND METHODS: 310 elderly patients (>80years of age) with stable CAD taking prolonged maintenance clopidogrel (75mg/day) were studied. Maximal platelet aggregation rate (MPA%) with light transmittance aggregometry and Platelet Reactive Units (PRU) with VerifyNow (VN) P2Y12 system were obtained. Markers of platelet activation, including PAC-1 and CD62P, were also determined. RESULTS: Patients on different stages of CKD presented similar MPA% and expression of PAC-1 and CD62P. Although severe CKD patients were more likely to present HPPR identified by VNP2Y12 (odds ratio: 1.85, p=0.038), multiple logistic regression diminished this effect (adjusted odds ratio: 1.19, p=0.642), and revealed anemia as a possible predictor of HPPR (adjusted odds ratio: 5.92, p=0.001). However, in a parallel way, hemoglobin correlated with baseline PRU values as well as with post-treatment values (r=-0.624 and r=-0.463, respectively, p<0.001). Association between hemoglobin and PRU inhibition rate was not found. Moreover, hemoglobin exerted no influence on MPA% at all. CONCLUSION: CKD is not necessarily associated with reduced antiplatelet effects of clopidogrel in elderly patients with stable CAD taking prolonged maintenance clopidogrel, and the seemingly influence of CKD on HPPR assessed by VNP2Y12 assay may be due to the artifactual effect of hemoglobin on VNP2Y12.

Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/tratamento farmacológico , Inibidores da Agregação de Plaquetas/uso terapêutico , Insuficiência Renal Crônica/diagnóstico , Ticlopidina/análogos & derivados , Idoso de 80 Anos ou mais , Plaquetas/efeitos dos fármacos , Clopidogrel , Doença da Artéria Coronariana/complicações , Creatinina/metabolismo , Feminino , Hemoglobinas/metabolismo , Humanos , Masculino , Razão de Chances , Selectina-P/metabolismo , Ativação Plaquetária , Agregação Plaquetária/efeitos dos fármacos , Receptores Purinérgicos P2Y12/metabolismo , Análise de Regressão , Insuficiência Renal Crônica/complicações , Fatores de Risco , Ticlopidina/uso terapêutico , Resultado do Tratamento
Appl Opt ; 50(31): G23-6, 2011 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-22086042


Interfacial microstructure tunable photovoltaic effects have been reported in heterojunctions of La(1-x)Ca(x)MnO(3) thin films and tilted or exact cut Nb-doped SrTiO(3) single crystal substrates under irradiation of UV pulsed laser. The photoresponse times of vicinal junctions and films were obviously faster than those of exact cut samples. The behaviors can be explained by the slope of the built-in electric field in the 10° tilted heterojunction and the interfacial terrace microstructure of La(1-x)Ca(x)MnO(3) films.

Am J Cardiol ; 103(6): 845-51, 2009 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-19268743


Subjects with heart failure (HF) and a preserved ejection fraction (EF) are heterogenous and the EF used to define this syndrome varies considerably among studies. We sought to determine if physiologic differences exist between subjects with a normal EF (>55%) or mildly decreased EF (40% to 55%). 357 consecutive Chinese patients who were healthy (n = 93) or had HF (n = 264) underwent comprehensive echocardiography, Doppler analysis, and measurement of neurohormones. Subjects with HF were stratified by EF into those with normal EF (>55%, n = 128), mildly decreased EF (40% to 55%, n = 38), or moderate to severely decreased EF (<40%, n = 100). Employing noninvasive pressure-volume analysis, estimated end-systolic and end-diastolic pressure-volume relations were calculated. Subjects with HF and an EF 40% to 55% more often had a previous myocardial infarction and diabetes than those with HF and an EF >55%. Physiologically, the cohort with a mildly decreased EF had eccentrically enlarged ventricles with evidence of remodeling (rightward shifted end-diastolic pressure-volume relation) and decreased chamber contractility (downward shifted end-systolic pressure-volume relation) most comparable to subjects with overt systolic HF. In conclusion, in subjects with HF and a preserved EF, there are distinct physiologic differences between those with a normal (>55%) and a mildly decreased (40% to 55%) EF.

Insuficiência Cardíaca/fisiopatologia , Ventrículos do Coração/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Insuficiência Cardíaca/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Volume Sistólico , Ultrassonografia , Função Ventricular Esquerda