Plasma level of plasminogen activator inhibitor-1 and C-peptide in correlation with coronary artery disease severity

Tissue plasminogen activator [t-PA] has been shown to be a promising agent in the treatment of coronary artery thrombosis associated with acute myocardial infarction [AMI]. A rapid inhibitor of t-PA has also been identified in human plasma, and plasma level of this inhibitor have been reported to be increased in patients with coronary artery disease [CAD]. Plasma level of Plasminogen Activator Inhibitor-I and C-Peptide were measured in 50 patients with myocardial infarction [MI] [12 patients with acute MI and 38 patients with old MI], 38 patients were males and 12 patients were females, their age ranged between 48 and 60 years [mean 55]. Coronary angiography was done in all patients to determine the severity of their coronary artery disease [CAD]. The patients were divided into single vessel disease 23 patients [46%] or multivessel disease 27 patients [54%]. According to the number of vessels involved and the results of plasma level of PAI-1 and C-Peptide correlated with the severity of CAD. Plasma level of PAI-1 and C-Peptide in patients with CAD were significantly higher than in 20 control subjects. High significant correlation was found between levels of PAI-I and C-Peptide and the severity of CAD. This study confirmed the significant correlation between plasma level of mean PAI-1 and C-Peptide and the severity of coronary artery disease documented by coronary angiography

Echocardiographic assessment of inhaled nitric oxide in newborn infants with severe hypoxemia

Nitric oxide inhalation can benefit newborn babies with persistent pulmonary hypertension with right to left extrapulmonary shunt [EPS]. We compared the effects of inhaled nitric oxide [NO] on systemic oxygenation and mean pulmonary blood flow velocity [MPBFV] using doppler ultrasound in severely hypoxic newborn infants with or without extrapulmonary shunt. With a median dose of 20 parts per million [ppm], oxygenation index decreased significantly in both groups [EPS, [p < 0.001] and non-EPS [p <0.05]]. The percentage decrease was significantly greater in the EPS group [p<0.001]. MPBFV increased significantly in the EPS group [p<0.001] only. There was significant correlation between the percentage decrease in oxygenation index and the percentage increase in MPBFV after 1 h of inhaled NO in the EPS group only. We conclude that inhaled NO may improve some newborn infants with severe hypoxemia without significant EPS by improving ventilation perfusion matching. Careful Doppler ultrasound could help to predict the likelihood of beneficial effects of inhaled NO. Nitric oxide being more effective in newborn infants with extrapulmonary shunting than those without by increasing pulmonary blood flow