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1.
DNA Cell Biol ; 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34851723

RESUMO

Mitochondria provide energy for various cellular activities and are involved in the regulating of several physiological and pathological processes. Mitochondria constitute a dynamic network regulated by numerous quality control mechanisms; for example, division is necessary for mitochondria to develop, and fusion dilutes toxins produced by the mitochondria. Mitophagy removes damaged mitochondria. The etiologies of peripheral neuropathy include congenital and acquired diseases, and the pathogenesis varies; however, oxidative stress caused by mitochondrial damage is the accepted pathogenesis of peripheral neuropathy. Regulation and control of mitochondrial quality might point the way toward potential treatments for peripheral neuropathy. This article will review mitochondrial quality control mechanisms, their involvement in peripheral nerve diseases, and their potential therapeutic role.

2.
J Atheroscler Thromb ; 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34853213

RESUMO

AIMS: We previously associated acute ST-elevation myocardial infarction (STEMI) with decreased plasma LL-37 levels. Therefore, this study investigated whether plasma LL-37 levels could predict ischemic cardiovascular events in patients after STEMI. METHODS: We prospectively collected peripheral plasma samples and clinical and laboratory data from consecutive patients who presented with STEMI and underwent primary percutaneous coronary intervention at Fuwai Hospital between April and November 2017. Enzyme-linked immunosorbent assay measured plasma LL-37 levels, and we followed the patients for 3 years. Major adverse cardiovascular events (MACEs) were a composite of all-cause mortality, reinfarction, unscheduled revascularization, or ischemic stroke. RESULTS: The study included 302 patients divided into high (≥ median) and low LL-37 level (<median) groups. The cumulative incidence of MACE (29.1% vs. 12.6%, p=0.0003), all-cause death (12.6% vs. 3.3%, p=0.003), reinfarction (7.1% vs. 2.0%, p=0.04), and unscheduled revascularization (13.0% vs. 5.4%, p=0.04) were higher in the low than those in the high LL-37 level group. Multivariable Cox regression analysis showed that higher LL-37 level independently predicted lower risks of MACE (hazard ratio [HR] 0.390; 95% confidence interval [CI] 0.227-0.669; p<0.001), all-cause death (HR 0.324; 95%CI 0.119-0.879; p=0.027), and unscheduled revascularization (HR 0.391; 95%CI 0.171-0.907; p=0.027). CONCLUSIONS: High basal plasma level of human LL-37 may predict lower 3-year risks of ischemic cardiovascular events in patients after STEMI.

3.
J Occup Environ Med ; 2021 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-34817454

RESUMO

BACKGROUND: Delayed retirement initiative is taken as one of the proposed solutions to population aging. Rare research attention has been paid to determinants in decisions-making of late retirement. METHOD: This study applies data from CHARLS survey (2018) that traces the health status among older adults in China, and implements the stepwise multiple regression analysis adjusted with robust standard errors on individual level. RESULTS: The difficulty in instrumental activities of daily living (IADLs) and chronic conditions could increase the intention of retirement-aged workers to withdraw from late career participation; and the overlay of both would interact to reinforce such intention. Besides, the employment-related social pension participation could further strengthen the jointly contributing effect of both on withdrawal from late career participation. CONCLUSION: The triple interaction mechanism in retirement-aged workers' decisions of late retirement needs considering in the policy formulation of delayed retirement initiative.

4.
Stem Cell Res Ther ; 12(1): 588, 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34823579

RESUMO

Skin wound healing is a multi-stage process that depends on the coordination of multiple cells and mediators. Chronic or non-healing wounds resulting from the dysregulation of this process represent a challenge for the healthcare system. For skin wound management, there are various approaches to tissue recovery. For decades, stem cell therapy has made outstanding achievements in wound regeneration. Three major types of stem cells, including embryonic stem cells, adult stem cells, and induced pluripotent stem cells, have been explored intensely. Mostly, mesenchymal stem cells are thought to be an extensive cell type for tissue repair. However, the limited cell efficacy and the underutilized therapeutic potential remain to be addressed. Exploring novel and advanced treatments to enhance stem cell efficacy is an urgent need. Diverse strategies are applied to maintain cell survival and increase cell functionality. In this study, we outline current approaches aiming to improve the beneficial outcomes of cell therapy to better grasp clinical cell transformation.

5.
Vet Microbiol ; 263: 109274, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34781192

RESUMO

Porcine proliferative enteropathy (PPE) is caused by the obligate intracellular bacterium Lawsonia intracellularis. Infection results in an enteric disease characterised by decreased growth performance of pigs, and presents a major economic burden for swine industries worldwide. Since vaccination is an effective technique for controlling PPE, novel effective vaccine platforms are need to be developed. In this study, five proteins of L. intracellularis were screened through animal experiments and the highly immunoprotective Omp2 protein was identified. Then, the immune efficacy of Omp2 was further evaluated based on humoral and cell mediated immune (CMI) responses, faecal bacterial shedding, histopathological lesions, immune barrier function of intestinal mucosa as well as digestive and absorptive capacity following challenge of mice with L. intracellularis. Mice immunised with Omp2 had reduced faecal shedding, fewer histopathological lesions and reduced bacteria colonisation of the ileum. Additionally, Omp2 immunised mice showed stronger serum IgG and IFN-γ levels, up-regulated Occludin and zonula occludens-1 (ZO-1) mRNA levels, as well as increased numbers of intestinal intraepithelial lymphocytes (IELs) and levels of sIgA. On the contrary, the activities of LPS, α-AMS and AKP were significantly increased. Our investigation indicated that immunization with Omp2 reduced the severity of clinical signs and provided efficacious immunoprotection for target animals against L. intracellularis infection in mouse model.

6.
Front Pharmacol ; 12: 744811, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34721033

RESUMO

Colorectal cancer is the third most common malignant disease worldwide, and chemotherapy has been the standard treatment for colorectal cancer. However, the therapeutic effects of chemotherapy are unsatisfactory for advanced and recurrent colorectal cancers. Thus, increasing the treatment efficacy of chemotherapy in colorectal cancer is a must. In this study, doxorubicin (DOX)-loaded tumor-targeting peptide-decorated mPEG-P(Phe-co-Cys) nanoparticles were developed to treat orthotopic colon cancer in mice. The peptide VATANST (STP) can specifically bind with vimentin highly expressed on the surface of colon cancer cells, thus achieving the tumor-targeting effects. The nanoparticles are core-shell structured, which can protect the loaded DOX while passing through the blood flow and increase the circulation time. The disulfide bonds within the nanoparticles are sensitive to the glutathione-rich microenvironment of tumor tissues. Rupture of disulfide bonds of the nanoparticles leads to the continuous release of DOX, thus resulting in the apoptosis of the tumor cells. The in vivo experiments in mice with orthotopic colon cancer demonstrated that the synthesized DOX-loaded tumor-targeting peptide-decorated polypeptide nanoparticles showed properties of drug delivery systems and exhibited good antitumor properties. The synthesized nanoparticles show appropriate properties as one of the drug delivery systems and exhibit good antitumor properties after encapsulating DOX.

7.
World J Surg Oncol ; 19(1): 318, 2021 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-34732226

RESUMO

BACKGROUND: Protective ileostomy is always applied to avoid clinically significant anastomotic leakage and other postoperative complications for patients receiving laparoscopic rectal cancer surgery. However, whether it is necessary to perform the ileostomy is still controversial. This meta-analysis aims to analyze the efficacy of ileostomy on laparoscopic rectal cancer surgery. METHODS: Cochrane Library, EMBASE, Web of Science, and PubMed were applied for systematic search of all relevant literature, updated to May 07, 2021. Studies compared patients with and without ileostomy for laparoscopic rectal cancer surgery. We applied Review Manager software to perform this meta-analysis. The quality of the non-randomized controlled trials was assessed using the Newcastle-Ottawa scale (NOS), and the randomized studies were assessed using the Jadad scale. RESULTS: We collected a total of 1203 references, and seven studies were included using the research methods. The clinically significant anastomotic leakage rate was significantly lower in ileostomy group (27/567, 4.76%) than that in non-ileostomy group (54/525, 10.29%) (RR = 0.47, 95% CI 0.30-0.73, P for overall effect = 0.0009, P for heterogeneity = 0.18, I2 = 32%). However, the postoperative hospital stay, reoperation, wound infection, and operation time showed no significant difference between the ileostomy and non-ileostomy groups. CONCLUSION: The results demonstrated that protective ileostomy could decrease the clinically significant anastomotic leakage rate for patients undergoing laparoscopic rectal cancer surgery. However, ileostomy has no effect on postoperative hospital stay, reoperation, wound infection, and operation time. The efficacy of ileostomy after laparoscopic rectal cancer surgery: a meta-analysis.


Assuntos
Laparoscopia , Neoplasias Retais , Anastomose Cirúrgica , Fístula Anastomótica/epidemiologia , Fístula Anastomótica/etiologia , Fístula Anastomótica/prevenção & controle , Humanos , Ileostomia , Complicações Pós-Operatórias/epidemiologia , Prognóstico , Neoplasias Retais/cirurgia
8.
Thromb J ; 19(1): 85, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34772417

RESUMO

AIM: The present study aimed to explore these characteristics, particularly thin-cap fibroatheroma (TCFA), in relation to residual syntax score (rSS) in patients who presented with acute MI. METHODS AND OUTCOMES: A total of 434 consecutive patients with MI aged ≥18 years who had STEMI underwent primary PCI. Notably, compared with other subgroups, the presence of TCFA in culprit lesions and a higher level of rSS, were significantly associated with MACE. When rSS was divided into three groups, high rSS levels were associated with a higher incidence of MACE, in the subgroups of without TCFA (P = 0.005), plaque erosion (P = 0.045), macrophage infiltration (P = 0.026), and calcification (P = 0.002). AUC of ROC curve was 0.794 and 0.816, whereas the AUC of the survival ROC was 0.798 and 0.846. CONCLUSION: The results of this study could be used in clinical practice to support risk stratification. TRIAL REGISTRATION: This study was registered at ClinicalTrials.gov as NCT03593928 .

9.
World J Clin Cases ; 9(30): 9285-9294, 2021 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-34786415

RESUMO

BACKGROUND: Colon cancer is a common malignant disease of the gastrointestinal tract and usually occurs at the junction of the rectum and sigmoid colon. Lymphatic and hematogenous metastases occur frequently in colon cancer and the most common metastatic sites include the liver, lung, peritoneum, bone, and lymph nodes. As a manifestation of advanced tumor spread and metastasis, soft tissue metastasis, especially skeletal muscle metastasis with bone metaplasia caused by colon cancer, is rare, accounting for less than 1% of metastases. CASE SUMMARY: A 43-year-old male patient developed skeletal muscle metastasis with bone metaplasia of the right proximal thigh 5 mo after colon cancer was diagnosed. The patient was admitted to the hospital because of pain caused by a local mass on his right thigh. Positron emission tomography-computed tomography showed many enlarged lymph nodes around the abdominal aorta but no signs of lung or liver metastases. Color ultrasound revealed a mass located in the skeletal muscle and the results of histological biopsy revealed a poorly differentiated adenocarcinoma suspected to be distant metastases from colon cancer. Immunohistochemistry showed small woven bone components that were considered to be ossified. CONCLUSION: This case reminds us that for patients with advanced colorectal tumors, we should be alert to the possibility of unconventional metastasis.

10.
Phytochemistry ; 193: 112981, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34653910

RESUMO

In this research, twenty aromatic and branched aliphatic polyketides, including seven previously undescribed butenolide derivatives, piterriones A-G and one known analogue, along with twelve known altenusin derivatives, were isolated from the isopod-associated fungus Pidoplitchkoviella terricola. Their structures were elucidated by analysis of NMR (1D and 2D) and mass spectrometry data, and their absolute configurations were determined by Mosher's method, microscale derivatization, and comparison of their specific rotations and ECD spectra. Dihydroaltenuene B exhibited mushroom tyrosinase inhibitory activity with an IC50 value of 38.33 ± 1.59 µM, which was comparable to that of the positive control, kojic acid (IC50 = 39.72 ± 1.34 µM). A molecular-docking study disclosed the hydrogen bonding interactions between the 3-OH and 4'-OH of dihydroaltenuene B and the His244, Met280 and Gly281 residues of tyrosinase.

11.
Artigo em Inglês | MEDLINE | ID: mdl-34647355

RESUMO

With many social challenges posed by an ageing population, the delayed retirement initiative has received wide attention from policymakers. However, China's current multi-level social health insurance system seems not perfect and not ready for the delayed retirement initiative. The public are generally concerned that the benefits of late retirees cannot be well guaranteed. Using data from China Health and Retirement Longitudinal Study (CHARLS) and the chorological design (CHARLS-2015 and -2018 waves), this study finds that (1) late retirement could be beneficial for physical health among older adults; (2) there have disparities between the effects of different social health insurances on physical health among older adults; (3) social health insurances could weaken the benefits of late retirement to physical health among older adults. Results imply that China's current multi-level social medical insurance system may lag behind the proposed delayed retirement initiative and have policy limitations for late retirees.

12.
Artigo em Inglês | MEDLINE | ID: mdl-34628522

RESUMO

OBJECTIVE: The Slash (multiple-job holders) become increasingly prevalent in the labor force under the context of fast-developing gig economy and other emerging employment forms active on platforms. However, health outcomes of multiple-job holding have not received sufficient research treatment and is far from reaching consensus. This study provides an empirical investigation on the influence of multiple-job holding on individual health. METHOD: This study uses data from China Health and Retirement Longitudinal Study (CHARLS-2015 survey) which covers 28 provinces/municipalities in China and tracks work and health status of the population aged over 45 years using stratified random sampling (N = 12,659-16,526 for examinations of different types of health status (i.e., chronic conditions/body aches/depression, in study 1), and from the Survey of Household Economics and Decision-making (SHED-2019) which is conducted by the Federal Reserve Board of the United States and documents economic behavior and related risks of the population aged over 18 years (N = 6603 for baseline model and N = 10,718 for supplementary test, in study 2). To address the potential endogeneity of multiple-job holding, the instrumental variable (IV) regressions are conducted to ensure the validity of results. The implementation of Study 1 and 2 in different national context could help test the generalization of research results. RESULTS: Compared with non-multiple jobs holding, multiple-job holding with only one additional job is associated with better health status (i.e., less chronic conditions and body aches, a lower level of depression shown in study 1, and better self-assessed general health shown in study 2), however, multiple-job holding with at least two additional jobs turns to be associated with worse health status (shown in both study 1 and 2). These results show that the optimal level of multiple-job holding could be featured with one additional job besides the primary job. CONCLUSION: Multiple-job holding, with different structures, has both bright and dark side for health outcomes. To maintain an optimal level of multiple-job holding could benefit individual health.

13.
Stem Cell Res Ther ; 12(1): 561, 2021 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-34717769

RESUMO

Exosomes are extracellular vesicles secreted by various cells, mainly composed of lipid bilayers without organelles. In recent years, an increasing number of researchers have focused on the use of exosomes for drug delivery. Targeted drug delivery in the body is a promising method for treating many refractory diseases such as tumors and Alzheimer's disease (AD). Finding a suitable drug delivery carrier in the body has become a popular research today. In various drug delivery studies, the exosomes secreted by mesenchymal stem cells (MSC-EXOs) have been broadly researched due to their immune properties, tumor-homing properties, and elastic properties. While MSC-EXOs have apparent advantages, some unresolved problems also exist. This article reviews the studies on MSC-EXOs for drug delivery, summarizes the characteristics of MSC-EXOs, and introduces the primary production and purification methods and drug loading methods to provide solutions for existing problems and suggestions for future studies.

14.
J Inflamm Res ; 14: 5319-5335, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34703271

RESUMO

Background and Aim: The aim of prospective study was to determine the prognostic value of combined measures of plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) and pentraxin 3 (PTX3) according to the culprit-plaque morphology (plaque rupture versus plaque erosion) in relation to the in patients with acute ST-elevated myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention. Methods: A total of 434 patients with STEMI aged ≥18 years who underwent pre-intervention OCT imaging of culprit lesions between March 2017 and March 2019 were enrolled. Finally, 235 patients who meet the inclusion criteria were enrolled and the cohort was divided into 3 groups according to PCSK9 and PTX3 levels: group A: PCSK9 < median and Pentraxin 3 (N = 72/30.6%); group B: PCSK9 ≥ median or Pentraxin 3≥ median (N = 91/38.7%); group C: PCSK9 ≥ median and Pentraxin 3≥ median (N = 72/30.6%). MACEs were defined as a composite of all-cause death, myocardial infarction (MI) recurrence, and ischemic stroke, revascularization and heart failure. Outcomes: During a median follow-up of 2.01 years, 50 patients has occurred MACE. Two-year MACE was higher in group C (23/31.9%) than in group B (16/17.6%) and group A (11/15.3%) (p = 0.028). There was a correlation between PCSK9 and PTX3 (r = 0.302, p < 0.003). In multivariable analysis adjusted for age, gender, risk factors, and serum indexes, being in group C remained independently associated with an increased risk of MACE (hazard ratio [HR]: 2.90; p = 0.010), and group B tended to have higher MACE (HR: 1.76; p = 0.172) compared with group A. Among patients with plaque erosion by OCT, group C was independently associated with an increased risk of MACE (HR: 9.04; p = 0.048) after fully adjustment. However, the significant association was absence among patients with plaque rupture. Conclusion and Relevance: This study demonstrated the usefulness of combined measures of PCSK9 and PTX3 to enhance risk stratification in patients with STEMI especially among patients with plaque erosion. Patients with elevation of both PCSK9 and PTX3 had a markedly increased risk of MACE.

15.
ACS Appl Mater Interfaces ; 13(42): 49840-49849, 2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34637257

RESUMO

A comb-shape amphiphilic cationic side chain is proposed to well-balance the water sorption in anion exchange membranes (AEMs), in which the cationic group is in between of an ether-containing hydrophilic spacer and an alkyl hydrophobic spacer. By fully grafting the amphiphilic side chains onto polybenzimidazole (PBI), comb-shape amphiphilic microphase networks are well-developed in the AEMs, in which the alkyl hydrophobic network greatly restricts water swelling and the ether-containing hydrophilic network keeps the hydration of the cationic groups and enlarges the ion conductive channel. The as-prepared membranes achieve a high conductivity of about 91.2 mS cm-1, an extremely low swelling ratio of about 8.1% at 80 °C, and good mechanical properties at a hydrated state (tensile strength and elongation at a break of about 14.6 MPa and 77.5%, respectively). Benefits from the balanced water sorption in AEMs, the H2/O2 fuel cell with a 10 µm ultrathin membrane could withstand 80 °C and 0.1 MPa back pressure and achieve a high open circuit voltage of about 1.0 V and a high peak power density of about 631.5 mW cm-2. This work provides a new insight into the design of high-performance AEM.

16.
Medicine (Baltimore) ; 100(37): e27083, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34664832

RESUMO

RATIONALE: Anal canal adenocarcinoma is a kind of rare malignant tumor of the intestinal tract with a low incidence rate. PATIENT CONCERNS: A 42-year-old man came to our department with anal tenderness accompanied by intermittent drainage of mucus discharge for 2 weeks. DIAGNOSES: The computer tomography showed a strip-shaped high-density shadow in the rectal wall. The magnetic resonance imaging showed a cyst-like mass of about 33 × 57 × 30 mm in the anal area. The lesion penetrated the anal canal, and plaque-shaped high signal shadow can be seen in the left side of the anus. The intraoperative pathology indicated the mass as anal canal adenocarcinoma. INTERVENTIONS: The abdominal perineal resection was performed for this patient. The postsurgical pathology showed that the tumor was anal canal adenocarcinoma with large amounts of mucus. OUTCOMES: The patient recovered well and was discharged from our department at 12th day post-surgery. This patient received further pelvic radiotherapy. LESSONS: Anal canal adenocarcinoma is a kind of malignant tumor that is extremely rare clinically. Computer tomography, magnetic resonance imaging, coloscopy, and histopathology are vital for the diagnosis of anal canal adenocarcinoma. Comprehensive treatment, including abdominal perineal resection, radiotherapy, and chemotherapy, is important for the treatment of anal canal adenocarcinoma.


Assuntos
Neoplasias do Ânus/diagnóstico , Neoplasias do Ânus/cirurgia , Adenocarcinoma/diagnóstico , Adenocarcinoma/cirurgia , Adulto , Humanos , Masculino , Protectomia/métodos , Radioterapia/métodos , Tomografia Computadorizada por Raios X/métodos
17.
Front Cell Dev Biol ; 9: 731393, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34712663

RESUMO

Tumor dormancy, a state of tumor, is clinically undetectable and the outgrowth of dormant tumor cells into overt metastases is responsible for cancer-associated deaths. However, the dormancy-related molecular mechanism has not been clearly described. Some researchers have proposed that cancer stem cells (CSCs) and disseminated tumor cells (DTCs) can be seen as progenitor cells of tumor dormancy, both of which can remain dormant in a non-permissive soil/niche. Nowadays, research interest in the cancer biology field is skyrocketing as mesenchymal stem cells (MSCs) are capable of regulating tumor dormancy, which will provide a unique therapeutic window to cure cancer. Although the influence of MSCs on tumor dormancy has been investigated in previous studies, there is no thorough review on the relationship between MSCs and tumor dormancy. In this paper, the root of tumor dormancy is analyzed and dormancy-related molecular mechanisms are summarized. With an emphasis on the role of the MSCs during tumor dormancy, new therapeutic strategies to prevent metastatic disease are proposed, whose clinical application potentials are discussed, and some challenges and prospects of the studies of tumor dormancy are also described.

18.
Front Pharmacol ; 12: 632075, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34650427

RESUMO

Background: The Global Registry of Acute Coronary Events (GRACE) risk score (GRS) is an established powerful model in predicting prognosis of patients with acute coronary syndrome. However, it does not contain pathophysiological biomarkers. Myeloperoxidase (MPO) and trimethylamine N-oxide (TMAO) are novel biomarkers of different pathophysiological processes of acute myocardial infarction, and each of them predicts risk of adverse clinical outcomes. We aimed to investigate whether the addition of MPO and TMAO could improve a GRS-based prediction model in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A prospective cohort of 444 consecutive patients with STEMI who underwent primary percutaneous coronary intervention were enrolled in this study. Plasma levels of MPO and TMAO were measured using samples collected before the interventional procedure. GRS at admission was calculated. Death and nonfatal myocardial infarction were recorded as major adverse cardiac events (MACEs). Kaplan-Meier survival analysis with Cox proportional-hazards regression was used to identify predictive values of MPO and TMAO. Area under the receiver-operator characteristic curve (AUC) and net reclassification improvement (NRI) were calculated to evaluate the increment of predictive value for the combination of MPO and TMAO with GRS in predicting adverse clinical outcomes. Results: During 6 months follow-up, 27 patients suffered MACEs. Both MPO (hazard ratio [HR]: 2.55, 95% confidence interval [CI]: 1.11-5.87; p < 0.05) and TMAO (HR: 4.50, 95% CI: 1.78-11.40, p < 0.01) predicted MACEs at 6 months. The AUC for MPO, TMAO, GRS, and their combination in predicting risk of MACEs at 6 months is 0.642, 0.692, 0.736, and 0.760, respectively. The addition of MPO and TMAO significantly improved the net reclassification of GRS for predicting MACEs at 6 months (NRI: 0.42, p = 0.032). Conclusion: Plasma MPO and TMAO each predict near-term risk of adverse outcomes in patients with STEMI. Furthermore, the combination of MPO and TMAO with GRS enables more accurate prediction of cardiovascular events compared with GRS alone.

19.
J Atheroscler Thromb ; 2021 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-34544957

RESUMO

AIMS: Culprit-plaque morphology [plaque rupture (PR) and plaque erosion (PE)] and high-risk plaques (HRP) identified by optical coherence tomography (OCT) and residual SYNTAX score (rSS) have been reported to influence clinical outcomes. Thus, in this study, we aimed to investigate the prognostic implication of culprit-plaque morphology and rSS for major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: Based on plaque morphology and rSS, 274 STEMI patients were divided into 4 groups: PE/low-rSS (n=61), PE/high-rSS (n=58), PR/low-rSS (n=55), and PR/high-rSS (n=100). According to HRP and rSS, patients were stratified to non-HRP/low-rSS (n=97), non-HRP/high-rSS (n=109), HRP/low-rSS (n=19), and HRP/high-rSS (n=49). MACE was defined as the composite of all-cause death, recurrence of myocardial infarction, stroke, and unplanned revascularization of any coronary artery. RESULTS: During the follow-up of 2.2 years, 47 (17.2%) MACE were observed. Patients with PR/high-rSS and HRP/high-rSS presented lower survival probability on revascularization and MACE. In fully adjusted analyses, PR/high-rSS group presented higher MACE risk than PE/low-rSS (HR: 4.80, 95% CI: 1.43-16.11, P=0.025). Patients with non-HRP/high-rSS (HR: 2.90, 95% CI: 1.01-8.38, P=0.049) and HRP/high-rSS (HR: 8.67, 95% CI: 2.67-28.21, P<0.001) presented higher risk of cardiac events than non-HRP/low-rSS. Adding rSS and HRP to the risk prediction model increased the C-statistic to 0.797 (95% CI: 0.737-0.857), with ΔC-statistic of 0.066 (P=0.002) and the NRI (46.0%, 95% CI: 20.5-56.8%, P<0.001) and IDI (8.7%, 95% CI: 3.6-18.2%, P<0.001). CONCLUSION: High-risk plaques in combination with rSS enhanced the predictive ability for MACE, indicating culprit-plaque features and residual atherosclerosis burden should be taken into account in risk stratification of STEMI patients.

20.
J Inflamm Res ; 14: 4409-4419, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34511975

RESUMO

Background: Culprit­plaque morphology [plaque rupture (PR) and plaque erosion (PE) identified by optical coherence tomography (OCT)] and biomarker of vascular inflammation, pentraxin-3 (PTX3), have been reported to influence clinical outcomes in coronary diseases. We aimed to investigate the prognostic implication of culprit-plaque morphology and plasma PTX3 for major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 236 patients were enrolled and divided into four groups: PE/low-PTX3 (n = 57), PE/high-PTX3 (n = 47), PR/low-PTX3 (n = 78) and PR/high-PTX3 (n = 54). MACE was defined as the composite of all-cause death, recurrence of myocardial infarction, stroke and unplanned revascularization of any coronary artery. Results: During the follow-up of 1.9 years, a total of 40 (16.9%) MACE were observed: 5.3% (3 patients) among patients with PE/low-PTX3, 21.3% (10 patients) among patients with PE/high-PTX3, 17.9% (14 patients) among patients with PR/low-PTX3 and 24.1% (13 patients) among patients with PR/high-PTX3 (Log rank P = 0.013). In fully adjusted analyses, patients with high-PTX3 were associated with higher MACE risk (HR: 2.40, 95% CI: 1.26-4.57, P = 0.008). Patients with PR/high-PTX3 (HR: 5.63, 95% CI: 1.57-20.16, P = 0.008) and PE/high-PTX3 (HR: 5.44, 95% CI: 1.46-20.29, P = 0.012) presented higher MACE risk than those with PE/low-PTX3. Adding plasma PTX3 levels and PR to the risk prediction model increased the area under curves to 76.1% (95% CI: 67.6-84.5%) and the NRI (28.1%, 95% CI: 0.3-48.3%, P=0.040) and IDI (2.4%, 95% CI: 0.1-12.9%, P = 0.040). Conclusion: Patients with PR/high-PTX3 and PE/high-PTX3 presented a poorer prognosis than those with PE/low-PTX3. Combining the culprit-plaque morphology with PTX3 enhanced the predictive ability for MACE and contributed to better identification of high-risk patients. Trial Registration Number: This study is registered at clinical trials.gov as NCT03593928.

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