Background:Research on the relationship between sarcopenic obesity (SO) and multiple cardiovascular diseases is limited, and the regulatory roles of the Aggregate Index of Systemic Inflammation (AISI) and Systemic Inflammation Response Index (SIRI) remain underexplored. Methods:This retrospective observational study included participants aged ≥50 years who underwent routine health examinations between January 1 and December 31, 2024. SO was defined as a low skeletal muscle mass-to-weight ratio (< 33.9% in females, <39.3% in males) and high visceral fat area (≥100 cm2). Participants were categorized into four groups: normal, sarcopenia, obesity, and SO. Adjusted multivariate analysis examined the association between SO and cardiovascular multimorbidities. The moderating effects of AISI and SIRI were analyzed using the Johnson-Neyman method and SPSS Process Macro. Results:This cross-sectional study included 1,010 participants aged ≥50 years. SO was significantly associated with endothelial dysfunction, arterial stiffness, degenerative heart valve disease, and carotid atherosclerosis, with odds ratios (95% confidence intervals) of 1.575 (1.017, 2.441), 1.382 (1.050, 1.818), 1.664 (1.033, 2.681), and 1.430 (1.022, 2.001), respectively. The Johnson-Neyman test identified AISI = 133.48 and SIRI = 0.58 as critical points for significant associations. Conclusion:SO is independently associated with increased cardiovascular disease risk. AISI and SIRI serve as biomarkers for risk stratification, highlighting the need for targeted management to improve cardiovascular outcomes in patients with SO.

Precise imaging of atherosclerotic plaques using biomarkers could prompt the diagnosis and clinical management of atherosclerosis (AS)-driven cardiovascular diseases. MicroRNA-155 (miR-155) plays a critical role in AS development, with its expression notably upregulated in foam cells within plaques. However, miRNA imaging methods for atherosclerotic plaques face significant challenges, including low specificity, inefficient delivery, and poor cell selectivity. Herein, we develop an endogenous hypochlorous acid (HClO)-gated cascade signal amplification strategy for precise miR-155 imaging in living foam cells, enabling accurate in vivo and ex vivo detection of atherosclerotic plaques. This strategy utilizes a phosphorothioate (PT)-modified hairpin probe that is specifically deprotected by HClO and uncaged by miR-155, triggering a catalytic hairpin assembly (CHA) to amplify fluorescence signals. The PT-CHA probes are encapsulated in lipid nanoparticles (LNs), followed by conjugating with phosphatidylserine (PS)-binding peptide (PBP) for selectively targeting foam cells, enabling in vivo miR-155 imaging in atherosclerotic plaques. The fluorescence intensity of PT-CHA@LN-PBP in the aorta region shows clear differentiation among AS-bearing mice, miR-155-/- mice, and healthy mice. Moreover, the fluorescence intensity strongly correlates with plaque area and AS progression and can discriminate plaque vulnerability risk with an area under the curve (AUC) of 0.94. Imaging of human aortic tissues further validates the probe's capacity to distinguish atherosclerotic plaques from normal endarterium. These findings establish PT-CHA@LN-PBP as a noninvasive, reliable diagnostic tool for precise assessment of AS.

Background Intensive care unit-acquired weakness is a prevalent complication among critically ill patients, associated with heightened mortality rates, extended durations of mechanical ventilation and hospital stays, as well as diminished mobility and unfavorable prognoses. Early diagnosis of intensive care unit-acquired weakness and identification of its subcategories are essential for early implementation of targeted interventions and care strategies. Nevertheless, there remains a significant gap in the availability of widely accepted, accurate, and user-friendly diagnostic tools for intensive care unit-acquired weakness. Objective The aim of this research was to conduct a comprehensive review of pertinent studies on diagnostic tools for intensive care unit-acquired weakness in critically ill patients, summarizing their diagnostic efficacy and constraints to aid healthcare professionals in choosing suitable diagnostic tools for intensive care unit-acquired weakness. Methods The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement were utilized to direct the literature search, bias risk assessment and data extraction. The search databases included PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL. The search period was from the inception of the database to 1 July 2024. Different types of risk bias assessment tools were used for different types of studies. Due to the heterogeneity of the data, solely a narrative synthesis of the intensive care unit-acquired weakness diagnostic tool was performed in this study. Results A total of 38 observational studies were included in the study. In the included studies, the gold standard for intensive care unit-acquired weakness diagnosis include the Medical Research Council score, muscle biopsy and electrophysiologic testing, potential diagnostic tools include the manual muscle test, electrophysiologic testing, imaging, serum inflammatory markers, neuromuscular ultrasound, and other parameters. In various studies, the diagnostic accuracy of intensive care unit-acquired weakness diagnostic tools has been inconsistent, with each tool possessing its own set of advantages and disadvantages. At present, no single tool is available for the definitive diagnosis of intensive care unit-acquired weakness, necessitating the combined use of multiple methods, each with inherent limitations. Manual muscle test is inexpensive and straightforward to perform, but it requires the patient to be conscious and cooperative. Muscle biopsy is invasive and rarely utilized. Electrophysiological testing can help differentiate whether intensive care unit-acquired weakness is caused by neural or muscular alterations, thereby aiding in the classification of its subtypes. However, it is moderately invasive, costly, and operator-dependent. Other diagnostic modalities, such as imaging and respiratory parameters, are under ongoing investigation. Conclusions The diagnostic tools available in intensive care unit-acquired weakness are varied, each with its own strengths and limitations. This study summarizes the current evidence on potential diagnostic tools for intensive care unit-acquired weakness and identifies possible future directions for these diagnostic tools. Registration PROSPERO Registration Number CRD42024573139.

Coronary artery calcification (CAC) is a common risk factor of cardiovascular disease. Although triglyceride glucose (TYG) index and high-density lipoprotein cholesterol (HDL-c) are both associated with CAC, no study has evaluated the correlation between the TYG/HDL-c ratio and CAC. In the present study, we investigated the relationships between CAC and the TYG index and the TYG/HDL-c ratio. A total of 9585 participants who underwent computed tomography (CT) screening for lung cancer from 2018 to 2020 were included in this cross-sectional study. Demographic data, laboratory test data and medical history data were collected from medical records. TYG = Ln[fasting glucose (mg/dL)×fasting TG (mg/dL/2]. The triglyceride glucose-HDL-c ratio was calculated as TYG/HDL-c. CAC was evaluated on chest CT images. Multivariate logistic regression analysis and restricted cubic splines were used to determine the relationships among the TYG index, TYG/HDL-c ratio and risk of CAC. The receiver operating characteristic (ROC) curve was used to evaluate the performance of the TYG index and TYG/HDL-c ratio in identifying CACs in individuals aged 60 years and above. CAC was detected in 2515 of 9585 participants (mean age 51.8 ± 15.5 years, 61.2

Currently, there is often a lack of suitable small-caliber graft vessels for treating cardiovascular diseases because of thrombosis and intimal hyperplasia. Tissue engineered vascular grafts (TEVGs) promise a potential solution to this issue. Acellular vascular matrix with good mechanical properties and biocompatibility is commonly used as a tissue engineered scaffold. In this study, acellular rat aortas were preloaded with heparin and hepatocyte growth factor (HGF) to fabricate small diameter TEVGs. In terms of the biomechanical properties, this scaffold was similar to native rat aortas. We implanted this scaffold into a rat abdominal aorta, and the acellular aorta with heparin only was used as control. The patency at 6 months of the two groups was 100%. At 1 month, a complete layer of endothelial cells could be seen on the surface of the vascular lumen of the scaffold with heparin and HGF. The results also showed that the intimal thickness was significantly reduced in the grafts coated with HGF compared to the control grafts. In conclusion, the small-diameter TEVGs constructed by acellular vascular scaffolds coated with heparin and HGF have a promising clinical application prospect.

Background:Heart failure (HF) is a chronic disease with a poor prognosis, making it extremely important to assess the prognosis of patients with HF for accurate treatment. Secreted modular calcium-binding protein 2 (SMOC2) is a cysteine-rich acidic secreted protein that plays a pathophysiological role in many diseases, including regulation of vascular growth factor activity. It has previously been found that SMOC2 plays an essential role in cardiac fibrosis in our previous preclinical study, but whether it can be used as a clinical marker in heart failure patients remains unclear. The purpose of this research was to evaluate the correlation between plasma levels of SMOC2 and the prognosis for individuals with HF. Methods:HF patients diagnosed with ischemic cardiomyopathy were enrolled from January to December 2021. Baseline plasma levels of SMOC2 were measured after demographic and clinical features were collected. Linear and nonlinear multivariate Cox regression models were used to determine the association between plasma SMOC2 and patient outcomes during follow-up. All analysis was performed using SPSS, EmpowerStats, and R software. Results:The study included 188 patients, and the average follow-up time was 489.5±88.3 days. The plasma SMOC2 concentrations were positively correlated with N-terminal pro-B-type Natriuretic Peptide (NT-proBNP), left ventricular end-diastolic diameter (LVEDd), and length of hospital stay and were negatively correlated with left ventricular ejection fraction (LVEF) at baseline. A total of 53 patients (28.2%) were rehospitalized due to cardiac deterioration, 14 (7.4%) died, and 37 (19.7%) developed malignant arrhythmias. A fully adjusted multivariate COX regression model showed that SMOC2 is associated with readmission (HR = 1.02, 95% CI:1.012-1.655). A significant increase in rehospitalization risk was observed in group Q2 (HR =1.064, 95% CI: 1.037, 3.662, p=0.005) and group Q3 (HR =1.085, 95% CI:1.086, 3.792, p=0.009) in comparison with group Q1. The p for trend also shows a linear correlation across the three models (P < 0.001). SMOC2 was associated with the severity of HF in patients, but not with all-cause deaths and arrhythmias during follow-up. Conclusion:Plasma SMOC2 is associated with the severity of HF and readmission rate, and is a good predictor of the risk of readmission in patients.

Objective To investigate the effects of atmospheric fine particulate matter(PM2.5)and ozone(O3-8 h)on the risk of admission to hospital for acute myocardial infarction(AMI)in Tianjin,and provide the evidence for the prevention of AMI.Methods The subjects were 2 530 inpatients diagnosed with AMI in the cardiology Department of Tianjin First Central Hospital from January 1,2018 to December 31,2021,and their basic information was recorded from the medical record system.The date of air pollutants and meteorological factors in the same period were provided by Tianjin Meteorological Bureau.Spearman correlation test and t-test were used to analyze the data,the time-stratified case-crossing study was used to analyze the effects of PM2.5 and O3-8h on hospitalization risk of AMI residents.The used software was SPSS 25.0.Results The daily average concentrations of PM2.5 and O3-8h in 6 districts of Tianjin from 2018 to 2021 were(50.42±39.08)and(98.86±57.30)μg/m3.After adjusting the meteorological factors,in the single pollutant model,the admission risk of AMI patients was the highest when the PM2.5 and O3-8 h increased by 10 μg/m3,and the lag time was 4 days(lag4),OR values were 1.026(95％CI:1.003-1.049)and 1.022(95％CI:1.002-1.043),respectively(P＜0.05).In the single-pollutant model,the seasonal,gender and age stratified analysis showed that PM2.5 increased the risk of AMI admission in lag0,lag1,lag2,lag4 and lag7,and the OR value of lag1 was the highest,which was 1.039(95％CI:1.016-1.062)in the cold season;PM2.5 increased the risk of AMI admission in ≥ 65 years old group only in lag4(OR=1.032,95％CI:1.001-1.063),P＜0.05;O3-8h exposure increased AMI admission risk in lag4 during the cold season(OR=1.077,95％CI:1.025-1.131),P＜0.05.In two-pollutant model and the multi-pollution model,there was no significant effect of PM2.5 concentration on AMI admission risk(P＞0.05);O3-8 h concentration increased by 10 µg/m3,the risk of admission of AMI patients increased in both the double pollutant model(O3-8h+PM10,O3-8h+CO,O3-8h+SO2,O3-8h+NO2,O3-8h+PM2.5)and multi-pollution(O3-8h+PM10+CO+SO2+NO2+PM2.5)model,and the OR value was the highest in the multi-pollutant model(OR=1.025,95％CI:1.005-1.046),P＜0.05.Conclusion In Tianjin,short-term exposure to PM2.5 and O3-8h both increased the risk of AMI admission,and active measures should be taken to control air pollution.At the same time,the protection of residents(≥ 65 years old)should be strengthened,and it should pay attention to the difference of admission risk between PM2.5 and O3-8h during cold and warm seasons.

Coronary artery ectasia (CAE) is a rare vascular phenotype characterized by abnormal dilation of blood vessels and disruption of coronary artery blood flow, which may promote thrombosis and an inflammatory response. We performed a cross-sectional study to investigate the association of white blood cells to mean platelet volume ratio (WMR) with CAE. Consecutive eligible patients (n = 492) were divided into two groups: including 238 patients with CAE and 254 patients in the normal coronary artery (NCA) group. WMR, the systemic immune-inflammation index (SII), and neutrophil-to-lymphocyte ratio (NLR) were found to be significantly associated with CAE in both univariate and multivariate logistic regression analyses. In multivariate analysis, the presence of WMR was associated with CAE (the odds ratios (OR) = 1.002, 95% CI: 1.001-1.003, P < .001). In the ROC analysis, the statistics (Z-values) of WMR vs SII and WMR vs NLR were 2.427 and 2.670 and were statistically significant (P = .015 and P = .008), indicating that WMR was superior to SII and NLR in distinguishing WMR. The optimal cut-off value was calculated from the point of maximal sensitivity and specificity by using Youden's index, which was determined to be 635.50. WMR has the potential to be a cost-effective tool to monitor CAE.

To investigate the association between time-of-day of stroke onset and functional outcome in patients with acute ischemic stroke(AIS) treated with endovascular thrombectomy(EVT). AIS patients treated with EVT between January 2013 and December 2018 were recruited and divided them into four 6-h interval groups according to the time-of-day of stroke onset. A total of 438 patients were enrolled, 3-month favorable outcome were achieved in 58.6%, 43.7%, 36.6%, and 30.5% of patients in the 00:00–06:00, 06:00–12:00, 12:00–18:00, and 18:00–24:00 groups, respectively (adjusted OR 0.61, 95% CI 0.40–0.93; p = 0.020). Compared with the 18:00–24:00 interval, patients in the 00:00–06:00 interval (adjusted OR 4.01, 95%CI 1.02–15.80, p = 0.047) and the 06:00–12:00 interval (adjusted OR 3.24, 95% CI 1.09–9.64, p = 0.034) were more likely to achieve favorable outcome. The time-of-day of stroke onset was not associated with 3-month mortality (adjusted p = 0.829), symptomatic intracerebral hemorrhage (sICH, adjusted p = 0.296), or early successful recanalization (adjusted p = 0.074). In conclusion, in AIS patients treated with EVT, those onsets either between 00:00 and 06:00 or between 06:00 and 12:00 appeared to be associated with a higher proportion of favorable outcomes at 3 months, but the time-of-day at stroke onset was not associated with the incidence of sICH, rate of early successful recanalization, or 3-month mortality.

We aimed to assess the impact of using enhanced stent visualization (ESV) systems on contrast media volume and radiation dose in percutaneous coronary intervention (PCI), especially for patients with chronic kidney disease (CKD). Coronary heart disease (CHD) is associated with chronic kidney disease (CKD), as they share a similar pathological pathway. In addition, the iodinated contrast media used for angiography is a risk factor for contrast-associated acute kidney injury (CA-AKI), which could aggravate the progression of CKD. We hypothesized that ESV systems have the potential to reduce the use of contrast media as well as the radiation dose; however, few studies have reported the impact on contrast media with the use of ESV systems. We retrospectively collected 124 patients with acute coronary syndrome who underwent PCI from May 2020 to July 2021. The patients were divided into the ESV-guided group (n = 64) and angiography-guided group (n = 60). Procedural parameters, including contrast media volume, radiation exposure (in Air Kerma-AK and Dose Area Product-DAP), number of cines, cine frames, fluoroscopy and procedure time, were recorded and analysed. The groups were comparable regarding the patient characteristics. There was a significant reduction in contrast media volume (174.7 ± 29.6 ml vs.132.6 ± 22.3 ml, p = 0.0001), radiation exposure (776 (499 - 1200) mGy vs. 1065 (791 - 1603) mGy, p = 0.002 in AK; 43 (37 - 73) Gycm2 vs. 80 (64 - 133) Gycm2, p = 0.030 in DAP) and procedure time (53.06 ± 21.20 min vs. 72.00 ± 30.55 min, p = 0.01) with the use of ESV systems. Similar results were observed in the subgroup analysis for the patients with CKD. This study suggested that the use of ESV is associated with reduced contrast media usage, radiation dose and procedure time during PCI. The same results were observed in a subgroup analysis in patients with CKD, and this shows that ESV-guided PCI has the potential to reduce renal impairment and mitigate the progression of CKD for those CHD patients with CKD.

BACKGROUND Research on microparticles is rapidly evolving and has extended to the field of many diseases. It is unclear whether microparticles can be stored frozen. In this study, our goal was to verify whether cryopreservation had an effect on the properties of the microparticles. MATERIAL AND METHODS We obtained C57BL/6J mouse-derived microparticles by grinding and gradient centrifugation. The specimens were divided into 2 groups: without dimethyl sulfoxide and with dimethyl sulfoxide. The microparticles were then stored at 25°C, 4°C, -20°C, -80°C, and -196°C for 0.5 days, 1 day, 3 days, 5 days, and 7 days. We tested whether the concentration, coagulation function, diameter distribution, and morphology of the microparticles in the 2 groups changed compared to those of a fresh sample. RESULTS We discovered that the concentrations of total microparticles, annexin V-positive microparticles, and brain-derived microparticles changed with freezing. The coagulation function, morphology, and size distribution of the microparticles were also affected by cryopreservation. Finally, there was no difference in the effects of cryopreservation on microparticles between the dimethyl sulfoxide group and the dimethyl sulfoxide-free group. CONCLUSIONS This study suggests that cryopreservation has diverse effects on microparticles within 1 week and that dimethyl sulfoxide has no protective effect on cryopreserved microparticles. Therefore, microparticles should be used fresh for future studies, and they should not be cryopreserved with or without dimethyl sulfoxide.

This study aims to compare and analyze lactate dehydrogenase (LDH), succinic dehydrogenase (SDH) and differences in capillary density level in the model of myocardial damage which caused by rats diabetes. The Wistar rats were divided into 4 groups, including control, diabetic, myocardial infarction and two diseases combined group. Ligate descending branch of left coronary artery on 1/3 position or inject streptozotocin into abdominal cavity to establish two kinds of disease models. After 6 w, obtain the myocardial tissues to do the vascular density analysis of tissue sections which are stained and cell tissue enzyme. Explore change of relevant index and differences among groups. Results indicated that degree of LDH and SDH decrease in two kinds of disease model. Compared with control group, level of myocardial vascular of myocardial injury group is higher, and diabetic group is higher than non diabetic group. Quantitative result of FFA in mitochondrial suspension of single disease group is higher than that of control group and two diseases combined group. Level of FFA and LDH of two diseases combined group is consistent with control group. In conclusion, after myocardial damage, which is caused by diabetes mellitus or myocardial infarction, degree of local vascularization increases, diabetes mellitus is more obvious. After myocardial damage, process of myocardial mitochondrial glycolysis and oxidative phosphorylation has some obstacles. But these two kinds of diseases all have cardiac muscle cell which can keep generated procedure of aerobic and anaerobic energy to instead the normal function of cardiac muscle.

Objectives To access the therapeutic effects of renal sympathetic denervation (RSD) onpost-myocardial infarction (MI) ventricular remodelling in canine, the most optimal time for treatment, and discuss its possible mechanism. Methods Thirty canines were randomly assigned to RSD1w + MI (MI 1 week after RSD, n = 6), MI1w + RSD(RSD one week after MI, n = 6), MI2w + RSD (RSD two weeks after MI, n = 6), Ngroup (Normal, n = 6), MI group (MI, n = 6). Establishing a canine model of precise acute myocardial infarction by ligating the left anterior descending (LAD) coronary artery, The first three groups of dogs received RSD 1 week before and 1 week, 2 weeks after myocardial infarction. And Blood samples were taken pre-embolization and 4 weeks after embolization, detection of endothelin-1(ET-1) and brain natriuretic peptide (BNP) levels. At the same time, echocardiography was performed to know cardiac function and heart size. Sacrificed all the dogs at end of experiment and the samples of cardiac and renal arteries was obtained. The expression of MMP-2, MMP-9 in the cardiac and the expression of TH in renal arteries were got by immunohistochemistry. Results (1) In MI group, the left ventricular ejection fraction of significantly declined (from 0.57 ± 0.03 to 0.41 ± 0.05, P < 0.05), plasmaBNP (from 27.91 ± 2.81 to 455.67 ± 47.88 pg/ml,P < 0.01), ET-1 (from 52.92 ± 10.53 to 99.47 ± 16.66 pg/ml, P < 0.05) and the expression of MMP-2, MMP-9 in cardiac was elevated; (2) Compared with MI group, the LVEF in RSD1w + MI, MI1w + RSD and MI2w + RSD group was significantly improved, respectively (all P < 0.05); LVEDd was significantly decreased after RSD; IVSd and LVPWd increased after RSD; the level of plasma BNP and ET-1 was significantly declined, and the expression of MMP-2, MMP-9 in cardiac was decreased after RSD; (3) The expression of TH in renal artery decreased after RSD. Conclusions RSD has preventive and therapeutic effects on post-MI heart failure, and its mechanism probably mediate through restraining renal sympathetic nervous activity and decreasing myocardial expression of MMP2, MMP-9.

BACKGROUND The plasma cystatin C concentration (PcyC) has been demonstrated to have prognostic value in acute coronary syndrome, but the study of PcyC in patients with borderline coronary lesions is limited. Moreover, the effects of atorvastatin and probucol on PcyC and the severity of coronary lesions are unknown. This study was to evaluate the effects of the combination of atorvastatin and probucol on PcyC and severity of coronary lesion in patients with borderline coronary lesions. METHODS One hundred and thirty consecutive patients with borderline coronary lesions (40% to 60% isolated single stenosis assessed by quantitative coronary angiography) were enrolled into the borderline coronary lesion (BCL) group, and one hundred and thirty-six subjects without coronary lesions comprised the controls (CTR). The subjects in the BCL group were randomized into routine treatment (RTT, n = 60), and combined treatment with atorvastatin 20 mg plus probucol 1.0 g daily added to routine medication (CBT, n = 70), both groups were treated for 6 months continuously. The levels of PcyC, high-sensitive C-reactive protein (hs-CRP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were determined. One hundred and four subjects in the BCL group were rechecked by coronary angiography. RESULTS PcyC levels were significantly higher in the BCL group than in the CTR group; (2003.26 ± 825.73) ng/ml vs. (1897.83 ± 664.46) ng/ml (P < 0.01). Compared with patients in the RTT group, the levels of PcyC, TC, LDL-C, TG and hs-CRP were significantly lower in the CBT group (P < 0.05). Moreover, there was a trend towards a slight decrease in the RTT patients, (54.38 ± 10.67)% vs. (50.29 ± 9.89)% (P > 0.05), and a significant decrease in the CBT patients, (53.65 ± 9.48%) vs. (40.38 ± 12.93)% (P < 0.05), in the mean percent stenosis of borderline coronary lesions before and after six months of treatment. CONCLUSIONS Cystatin C played an important role in the development of coronary artery disease, and was associated with the severity of coronary lesions. The combination of atorvastatin and probucol decreased PcyC levels, and could be the treatment of choice.

Background Randomized studies have shown beneficial effects of drug-eluting stent (DES) in reducing the risk of repeated revascularization. Other studies have shown higher proportion of death, myocardial infarction (MI) and increased cost concerning DES. However the long term safety and effectiveness of DES have been questioned recently.Methods To compare long term clinical outcomes, health-related quality of life (HRQOL) and cost-utility after sirolimus-eluting stent (SES) and bare metal stent (BMS) implantation in angina patients in China, 1241 patients undergoing percutaneous coronary revascularization (PCI) with either SES (n=632) or BMS (n=609) were enrolled continuously in this prospective, nonrandomized, multi-center registry study.Results Totally 1570 stents were implanted for 1334 lesions. Follow-up was completed in 1205 (97.1%) patients at 12 months. Rates of MI, all causes of death were similar between the two groups. Significant differences were found at rate of cardiovascular re-hospitalization (136 (22.4%) in BMS group vs. 68 (10.8%) in SES group, P=0.001) and recurrent angina (149 (24.5%) vs. 71 (11.3%), P=0.001). Dramatic difference was observed when compared the baseline and 9-month HRQOL scores intra-group (P < 0.001). However no significant difference was found inter-group either in baseline or follow-up HRQOL. Compared with SES, the total cost in BMS was significantly lower on discharge (62 546.0 vs. 78 245.0 Yuan, P=0.001). And follow-up expenditure was remarkably higher in the BMS group than that in the SES group (13 412.0 vs. 8 812.0 Yuan, P=0.0001).Conclusions There were no significant differences on death, in-stent thrombosis, MI irrespective of stent type. SES was superior to BMS on improvement of life quality. SES was with higher cost-utility compared to BMS. Chin Med J 2010;123(20):2797-2802

BACKGROUND:Adenosine phosphate-mediated platelet aggregation is a prognostic factor for major adverse cardiac events in patients who have undergone selective percutaneous coronary interventions. This study aimed to assess whether an adjusted loading dose of clopidogrel could more effectively inhibit platelet aggregation in patients undergoing selected percutaneous coronary intervention.METHODS:A total of 205 patients undergoing selected percutaneous coronary intervention were enrolled in this multicenter, prospective, randomized study. Patients receiving domestic clopidogrel (n = 104) served as the Talcom (Taijia) group; others (n = 101) received Plavix, the Plavix group. Patients received up to 3 additional 300-mg loading doses of clopidogrel to decrease the adenosine phosphate-mediated platelet aggregation index by more than 50% (the primary endpoint) compared with the baseline. The secondary endpoint was major adverse cardiovascular events at 12 months.RESULTS:Compared with the rational loading dosage, the tailored loading dosage better inhibited platelet aggregation based on a > 50% decrease in adenosine phosphate-mediated platelet aggregation (rational loading dosage vs. tailored loading dosage, 48% vs. 73%, P = 0.028). There was no significant difference in the eligible index between the Talcom and Plavix groups (47% vs. 49% at 300 mg; 62% vs. 59% at 600 mg; 74% vs. 72% at 900 mg; P > 0.05) based on a standard adenosine diphosphate-mediated platelet aggregation decrease of > 50%. After 12 months of follow-up, there were no significant differences in major adverse cardiac events (2.5% vs. 2.9%, P = 5.43). No acute or subacute stent thrombosis events occurred.CONCLUSION:An adjusted loading dose of clopidogrel could have significant effects on antiplatelet aggregation compared with a rational dose, decreasing 1-year major adverse cardiac events in patients undergoing percutaneous coronary interventions based on adenosine phosphate-mediated platelet aggregation with no increase in bleeding.

This article aims to investigate the changes of plasma cystatin C concentration (PcyC), and to evaluate the relationship between PcyC and acute coronary syndrome.

OBJECTIVE:To investigate the effect of autologous radial artery (RA) on coronary artery bypass grafting (CABG) in the elderly aged 65 years and older.METHODS:Three hundreds and twenty-two patients aged 65 years and older underwent CABG with autologous RA from January 2000 to March 2007. Peri-operative complication and mortality were observed and follow-up was performed.RESULTS:Three hundreds and forty-four RA grafts including 300 cases of single and 22 cases of bilateral RA were collected. The total number of distal anastomosis was 974, with the mean of (3.0 +/- 0.4). The mean of RA distal anastomosis was (1.1 +/- 0.4). There were 321 single, 16 Y or T composite and 7 sequential grafts of RA constructed. The distal end of RA was anastomosed to right coronary artery system for 234 times, to obtuse marginal for 95 times, to diagonal or intermediate ramous artery for 22 times. The proximal end of RA was anastomosed to aorta for 328 times, to left internal mammary artery for 9 times and to saphenous vein for 7 times. Only 13 patients manifested transient paresthesia in the area of radial aspect of thumb and no other complication occurred in the forearm. During hospitalization, 7 patients died. No patient died after the follow-up of (46.5 +/- 6.7) months. Seventy-three patients were performed with coronary angiography postoperatively. It was showed by coronary angiography that all RA conduits were patent after the duration of (47.5 +/- 11.2) months after CABG.CONCLUSION:Utilization of RA to CABG in the elderly is safe and effective.