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Background: Soluble growth stimulator gene 2 protein (sST2) is associated with heart failure and myocardial infarction; however, the predictive value of plasma sST2 level for coronary slow flow/no-reflow (CSF/NRF) is unclear. This study aimed to explore the predictive value of plasma sST2 levels for CSF/NRF in patients with ST-elevation myocardial infarction (STEMI) who underwent emergency percutaneous coronary intervention (PCI). Methods: A total of 242 STEMI patients who underwent emergency PCI at our hospital between November 2020 and July 2021 were enrolled in this study. According to the postprocedural procedure, these patients were divided into the CSF/NRF and control groups. Clinical data were collected from both groups and were used to explore the predictive value of serum sST2 levels for CSF/NRF. Results: Of the total 242 patients, CSF/NRF was observed in 50 patients (20.7%). Statistically significant differences (P < 0.05) were observed in age, diabetes mellitus, sST2 level, neutrophil-to-lymphocyte ratio (NLR), fasting blood sugar, preprocedural blood pressure, intraprocedural hypotension, N-terminal pro-B-type natriuretic peptide, MB isoenzyme of creatine kinase (CK-MB), and cardiac troponin I (cTNI). Multivariate analysis showed that the sST2 level, NLR, and intraoperative hypotension were independent risk factors for CSF/NRF. ROC curve analysis showed that the sensitivity and specificity of the sST2 level for predicting CSF/NRF were 68.0% and 75.5%, respectively, when the sST2 level was more than 64.6 ng/mL (AUC = 0.780, 95% CI: 1.003-1.020, P=0.009). Conclusion: For STEMI patients, preprocedural sST2 levels significantly correlated with CSF/NRF occurring in PCI. sST2 level is a potential predictor for CSF/NRF occurrence.
Assuntos
Hipotensão , Infarto do Miocárdio , Fenômeno de não Refluxo , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST , Humanos , Hipotensão/etiologia , Infarto do Miocárdio/etiologia , Fenômeno de não Refluxo/etiologia , Intervenção Coronária Percutânea/efeitos adversos , Curva ROC , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgiaRESUMO
BACKGROUND: To investigate the feasibility and accuracy of the Euro CTO (CASTLE)CTA score obtained on coronary computed tomography angiography (CCTA) for predicting the success of percutaneous coronary intervention (PCI) and the 30-min wire crossing in chronic total occlusions (CTO). METHOD: One hundred and fifty patients (154 CTO cases; median age, 61 (interquartile range [IQR], 54-68) years; 75.3% male) received CCTA at the People's Hospital of Liaoning Provincce within 1 month before the procedure. The Euro CTO (CASTLE) score obtained on CCTA(CASTLECTA) was calculated and compared with the Euro CTO (CASTLE) score obtained based on coronary angiography (CASTLECAG) for the predictive value of 30-min wire crossing and CTO procedural success. RESULTS: In our study, the CTO-PCI success rate was 89.0%, with guidewires of 65 cases (42.2%) crossing within 30 min. There were no significant differences in the median CASTLECTA and CASTLECAG scores in the procedure success group (3 [IQR, 2-4] vs 3 (IQR, 2-3]; p = 0.126). However, the median CASTLECTA score was significantly higher than the median CASTLECAG score in the procedure failure group (4 [IQR, 3-5.5] vs 4 [IQR, 2.5-5.5]; p = 0.021). There was no significant difference between the median CASTLECTA score and the median CASTLECAG score in the 30-min wire crossing failure group (3 [IQR, 3-4] vs 3 [IQR, 2-4]; p = 0.254). However, the median CASTLECTA score was significantly higher than the median CASTLECAG score in the 30-min wire crossing group (3 [IQR, 2-3] vs 2 [IQR, 2-3]; p < 0.001). The CASTLECTA score described higher levels of calcification than the CASTLECAG score (48.1% vs 33.8%; p = 0.015). There was no significant difference between the CASTLECTA score (area under the curve [AUC], 0.643; 95% confidence interval [CI], 0.561-0.718) and the CASTLECAG score (AUC, 0.685; 95% CI, 0.606-0.758) for predicting procedural success (p = 0.488). The CASTLECTA score (AUC, 0.744; 95% CI, 0.667-0.811) was significantly better than the CASTLECAG score (AUC, 0.681; 95% CI, 0.601-0.754; p = 0.046) for predicting 30-min wire crossing with the best cut-off value being CASTLECTA ≤ 3. The sensitivity, specificity, positive predictive value, and negative predictive value were 90.8%, 55.2%, 54.6%, and 87.0%, respectively. CONCLUSION: The CASTLECTA scores obtained from noninvasive CCTA perform better for the prediction of the 30-min wire crossing than the CASTLECAG score.
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Oclusão Coronária , Intervenção Coronária Percutânea , Pré-Escolar , Doença Crônica , Angiografia por Tomografia Computadorizada , Angiografia Coronária/métodos , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/terapia , Feminino , Humanos , Masculino , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/métodos , Sistema de Registros , Resultado do TratamentoRESUMO
Objective To investigate the neurotoxic effects ofLDN-57444, a specific ubiquitin C-termiual hydrolase L1 (UCH-L1) inhibitor, on dopaminergic neurons and the possible mechanism. Methods The viability of SK-N-SH cells exposed to 5, 10, 25, 50, 75 or 100 μmol/L LDN-57444 for 24 h was assessed using MTT assay, and the cell apoptosis was detected with Hoechst staining. Western blot was performed to identify the expressions of UCH-L1 protein, ubiquitin monomer and polyubiquitinated proteins, and the activity of the ubiquitin-proteasome system (UPS) was evaluated with fluorometry. Results After exposure to UCH-LI inhibitor for 24 h, the cell process-like structures of SK-N-SH cells diminished, and the cell body shrank and became spherical. Exposure to LDN-57444 resulted in concentration-dependent reduction of the cell viability, and the reduction became statistically significant following the exposure to 50 μmol/L LDN-57444, as compared with that in the control group (P<0.05). The exposure also resulted in obvious cell apoptosis as shown by nuclear fragmentation and presence of the apoptotie bodies. Western blot detected no obvious changes in UCH-L1 protein expression but identified reduced ubiquitin monomer and increased polyubiquitinated protein expression in the cells. Fluorometry showed reduced activity of UPS in the exposed cells. Conclusion UCH-L1 inhibitor produces neurotoxicity to dopaminergie neurons and induces cell apoptosis possibly as the result of impaired UPS activity and intracellular accumulation of polyubiquitinated proteins following the exposure.
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Objective To investigate the effects of different doses of pituitary adenylate cyclase- activating polypeptide(PACAP)on the functional and morphological outcome in a mice model of Parkinson' s disease(PD)rendered by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP).Methods Male mice were treated with PACAP 0.02, 0.20 or 2.00 ?g by iv bolus for 7 days after MPTP was administered, and were compared with the saline-treated mice.The immunohistochemistry and Western blot were used to detect the alterations of PD biomarker including tyrosine hydroxylase(TH), dopamine transporter(DAT)and vesicular monoamine transporter2(VAMT2).In addition, monoamine neurotransmitters in the striatum of mice were measured by the high performance liquid chromatography (HPLC).Results TH immunohistochemistry indicated that the number of TH-positive neurons in the substantia nigra was increased in all PACAP-treated mice(PACAP(0.02 ?g/d)group was 93.33?4.87, F=85.85,P