ABSTRACT
Objective To investigate the effect of CD40/CD40 ligand on the genesis and development of coronary artery disease (CAD),and the inhibitory effect of cyclosporine A (CsA) on CD40/CD40 ligand. Methods A total of 71 patients were divided into four groups:acute myocardial infarction group (AMI, n=19), unstable angina pectoris group (UAP, n=18), stable angina pectoris group (SAP, n=17) and normal control group (N, n=17). Flow cytometry was used to detect the expres?sion of CD40 and CD40L in peripheral blood mononuclear cells (PBMCs) of four groups. The group in which CD40 and CD40L were produced at the highest level was chosen, and a series concentrations of CsA(H1:0 mg/L, H2:0.01 mg/L, H3:0.1 mg/L, H4:1 mg/L)were used to treat the cells. Then the expressions of CD40 and CD40L were measured by flow cytome?try. Results Compared with N group,the expression of CD40 was significant higher in other groups (P0.05). The expression of CD40L was elevated and fol?lowed by different severity of CAD. There was significant difference in the expression of CD40L between groups (P<0.05) . AMI group showed the highest expression of CD40 and CD40L. After being treated with CsA, the expression of CD40 was higher in H1 group than that of H3 group and H4 group (P<0.05). The expression of CD40L was significantly higher in H1 group than that of other three groups (P < 0.05). Conclusion CD40 and CD40L may be involved in the development of CAD. Moreover, it might be restrained by CsA via regulation of CD40/CD40L.
ABSTRACT
Objective To investigate the incidence of depression of coronary artery bypass grafting before and after surgery in patients with coronary heart disease and the impact of depression on patients undergoing coronary artery bypass grafting.Methods 345 patients treat with CABG were divided into depression and non depression groups based on Serf-rating depression scale(SDS).Compare the change of different degree of depression occurrence rate before and after surgery.All patients were followed up for 24 months after procedure for the occurrence major adverse cardiovascular events(MACE),then make the non MACE survival analysis and Cox regression.Results Baseline data of BMI(body mass index) and history of hypertension,cerebrovascular disease was statistically significant difference between groups.Depression in patients after CABG was significantly higher than that before procedure(40.9％ vs 24.3％,P ＜0.05).The MACE rate was significantly higher in patients with post-procedure depression than that in patients without depression(16.5％ vs 5.2％,P ＜0.01),and the incidences of myocardial infarction and target lesion revascularization were also significantly higher in depression patients than in non-depression patients(6.8％ vs 2.1％,6.6％ vs 1.6％,P ＜ 0.05).There was no significant difference on accumulative mortality between two groups(3.3％ vs 1.6％,P =0.315).The survival analysis curve of Kaplan-Meier show the incidences of non MACE survival rate was significantly lower in depression patients than in non-depression patients (P ＜0.001).There was no significant difference on death survival analysis(P =0.309).Depression,old myocardial infarction and LVEF(left ventricular ejection fraction)were independent risk factors for MACE.Conclusion The proportion was higher in patients with post-procedure and pre-procedure who have different degree of depression,the MACE rate was significantly higher in patients with postprocedure depression than in patients without depression.Depression is dangerous factors for prognosis of patients with coronary artery bypass grafting.