ABSTRACT
BACKGROUND AND OBJECTIVES: Cigarette smoking is a risk significant factor in coronary artery disease (CAD) and vasospastic angina (VSA). However, it is largely unknown whether smoking adds to any long-term clinical risk in VSA patients. SUBJECTS AND METHODS: A total of 2797 patients without significant CAD underwent acetylcholine (Ach) provocation test between November 2004 and October 2010. Patients were divided into three groups, based on the presence of coronary artery spasm (CAS) and smoking habits (non-CAS group: n=1188, non-smoking CAS group: n=1214, smoking CAS group: n=395). All CAS patients were prescribed with anti-anginal medications for at least 6 months. The incidence of major clinical outcomes and recurrent angina of these groups were compared up to 3 years. RESULTS: There were considerable differences in the baseline clinical and angiographic characteristics among the three groups, but there was no difference in the endpoints among the three groups (including individual and composite hard endpoints) such as death, myocardial infarction, de novo percutaneous coronary intervention, cerebrovascular accident, and major adverse cardiac events. However, there was a higher incidence of recurrent angina in both the non-smoking CAS group and smoking CAS group, as compared to the non-CAS group. In multivariable adjusted Cox-proportional hazards regression analysis, smoking CAS group exhibited a higher incidence of recurrent angina compared with the non-CAS group (hazard ratio [HR]; 2.46, 95% confidence interval [CI]; 1.46-4.14, p=0.001) and non-smoking CAS group (HR; 1.76, 95% CI; 1.08-2.87, p=0.021). CONCLUSION: Cigarette smoking CAS group exhibited higher incidence of recurrent angina during the 3-year clinical follow-up compared with both the non-CAS group and non-smoking CAS group. Quitting of smoking, paired with intensive medical therapy and close clinical follow-up, can help to prevent recurrent angina.
Subject(s)
Humans , Acetylcholine , Coronary Artery Disease , Coronary Vessels , Follow-Up Studies , Incidence , Myocardial Infarction , Percutaneous Coronary Intervention , Smoke , Smoking , Spasm , Stroke , Tobacco ProductsABSTRACT
Objective To investigate the curative effect of Candesartan on chronic systolic heart failure in Tibetan pla?teau. Methods A total of 526 patients with chronic systolic heart failure were divided into two groups randomly (Treatment group N=252;Control group N=274). Regular medicines, such as cardiac, diuretic and vasodilator drugs , are given to pa?tients in both groups according to their primary underlined diseases. Additionally, enalapril is added in control group, while candesartan is added in treatment group. Improvement of cardiac function, LVEF, LVEDD and blood pressure were compared between these two groups after 8 weeks. Results There was no significant difference in effective rate (i.e., 45.2%in treat?ment group and 44.9% in control group, respectively), efficiency rate (i.e. 54.8% in treatment group and 55.1% in control group, respectively) and inefficiency rate (i.e. 2.0%in treatment group and 2.2%in control group, respectively) between treat?ment and control groups . After treatment, LVEF in the two groups are all improved, while LVEDD and blood pressure both de?creased with statistical significance. However, the difference between the two groups is not significant. Conclusion No sta?tistical difference was found in curative effect on chronic systolic heart failure in Tibetan Plateau between two groups.
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Objective To evaluate the value of two-dimensional (2D) and color Doppler ultrasonography and B-blood flow (B-flow) in quick screening for venous diseases of the lower extremities in late pregnant women. Methods Sixty late pregnant women excluding other-cause blood vessel diseases were recruited during September 2007 to January 2008 and underwent 2D and color Doppler ultrasonography and B-blood flow examinations for diameter and blood flow velocity of the veins in their both lower extremities during prenatal and postnatal periods to record intravenous condition, activities of the venous valve and venous valvular regurgitation in detail. Results Diameters of the veins in beth lower extremities of the late pregnant women widened significantly during prenatal period, as compared to that in postnatal period [(11.5±1.5) mm vs. (8.4±1.0) mm, t =7.14, P <0.01] and their blood flow velocity slowed down significantly in prenatal period than that in postnatal period [(11.5±4.0) cm/s vs. (29.7±6.9) cm/s, t =-15.74, P <0.01]. Spontaneous enhancement phenomenon could be shown in their veins in 57 of 60 (95%) pregnant women by 2D and color Doppler ultrasonography, but could not be shown by 2D and color Doppler uhrasonography in the poplitel veins in 21 pregnant women (35%) or in the small and great saphenous veins in 39 pregnant women (65%), which should be activated by B-flow. Venous valvular regurgitation occurred in the great saphenous veins and the superficial femoral veins in 24 percent of pregnant women during prenatal period, and small venous valve bag thrombus formed in 20 percent of the superficial femoral veins and 10 percent of the great saphenous veins, but disappeared two weeks after delivery, without formation of pulmonary embolism. Conclusion Tow-dimentional and color Doppler ultrasonography and B-blood flow examinations can be used in late pregnant women to quickly screen for venous diseases in their lower extremities.
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Objective To achieve the fusion expression of the entire human beta-defensin-3(hBD-3) gene. Method We synthesized two oligonucleotide primers accor ding to the codon preference of Escherichia coli. The gene was cloned into p GEX -4T-2 to establish the pGEX-4T-2-hBD-3 as the fusion expression vector by PCR. Transformed into E.coli strain DH5α, the express vector was induced an d ex pressed by IPTG. The fusion protein GST-hBD-3 was obtained by repeated cycles of freezing and thawing, cut by thrombin to attain the recombinant hBD-3 protei n. Result The result of the antibacterial peptide agarose diffu sion assay shows the antibacterial activity of the rhBD-3 against the S.aureu s exists, and it reaches 0.843U. Conclusion The fusion expr ession of the hBD-3 gene is successful.