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<p><b>OBJECTIVE</b>To explore the relationship between plasma microRNA126 (miR-126) level and coronary collateral circulation (CCC) formation and to determine whether the miR-126 in plasma could serve as a blood-based biomarker for CCC in patients with severely narrowed coronary arteries (CAD).</p><p><b>METHODS</b>In this prospective study, a total of 120 consecutive CAD patients with ≥ 95% stenosis in one epicardial coronary artery were enrolled. Thirty healthy people served as normal control. They were divided into two groups according to Rentrop grades: patients with grade 2 and 3 collateral development (good CCC group, n = 64) and patients with grade 0 and 1 collateral development (poor CCC group, n = 56). Plasma miR-126 was measured by RT-PCR and serum VEGF was evaluated by ELISA method.</p><p><b>RESULTS</b>Fasting plasma glucose (FPG) was significantly lower in patients with good CCC than in patients with poor CCC ((5.99 ± 1.48) mmol/L vs. (6.40 ± 2.50) mmol/L). Plasma miR-126 levels and VEGF levels were significantly lower in CAD patients than in healthy people (0.04 ± 0.01 vs. 0.07 ± 0.02, P = 0.023 and (2 110 ± 455) ng/L vs. (2 574 ± 450) ng/L, P = 0.011, respectively). miR-126 and VEGF levels were significantly higher in good CCC group than in poor CCC group (miR-126: 0.06 ± 0.02 vs. 0.03 ± 0.01, P = 0.021;VEGF:(2 549 ± 614) ng/L vs. (1 759 ± 452) ng/L, P = 0.008) . In CAD patients with good CCC, the miR-126 level was positively correlated to the VEGF expression (r = 0.712, P = 0.005) while there was no correlation between miR-126 level VEGF in CAD patients with poor CCC (r = 0.342, P = 0.483) . Multivariate analysis revealed that plasma miR-126 (OR = 2.145, 95% CI 1.691-2.988, P = 0.001) and VEGF (OR = 1.279, 95% CI 1.068-2.295, P = 0.013) were independent predictors of collateral formation in patients with severely narrowed coronary arteries. In CAD patients, the area under the miR-126 ROC curve is 0.951 (P = 0.002).</p><p><b>CONCLUSION</b>Plasma miR-126 level is positively correlated to the CCC formation and is an independent predictor of CCC development in patients with severely narrowed coronary arteries, suggesting that plasma miR-126 might be a useful new, stable blood biomarker for predicting CCC formation in patients with severely narrowed coronary arteries.</p>
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Humans , Biomarkers , Collateral Circulation , Coronary Angiography , Coronary Artery Disease , Blood , Coronary Circulation , Coronary Disease , Heart , MicroRNAs , Blood , Multivariate Analysis , Plasma , Prospective Studies , ROC CurveABSTRACT
Objective To observe the changes of serum levels of inflammatory cytokines in the elder patients with clopidogrel resistance (CLR) after coronary stenting. Methods A total of 93 patients with unstable angina pectoris received coronary stenting were enrolled, and peripheral blood samples were taken before and 24 hours, 1 week and 1 month after surgery. The platelet aggregation (PAG) induced by adenosine diphosphate (ADP) were detected, and all patients were divided into CLR group (n=33) and normal response group (n=60) according to PAG response. At the same time, the levels of C-reactive protein (CRP), soluble fragment of CD40 ligand (sCD40L) and P-selectin were detected by enzyme-linked immunosorbent assay. Results The incidences of CLR were 35. 5% (33/93), 26. 9%(25/93) and 20. 4%(19/93) respectively 24 hours, 1 week and 1 month after surgery. The levels of CRP C(8. 8 ± 2. 5) mg/L at 24 hours, (5. 3 ± 2. 5) mg/L at 1 week], P-selectin [(73. 8±34)×10~(-3) ng/L at 24 hours, (70. 5±31. 6)×10~(-3) ng/L at 1 week, (66. 4±22. 3) ×10~(-3) ng/L at 1 month] and sCD40L C(7. 7 ±2. 3)×10~(-3) ng/L at 24 hours] after surgery in CLR group showed significant differences comparing with pre-surgery and normal response group (all P< 0.05). The CLR at 30 days after coronary stenting was significantly correlated with the level of P-selectin (r=1.334) and smoking (r= 1.053). Conclusions The levels of CRP, P-selectin and sCD40L in some elder patients after coronary stenting are increased and may be correlated with CLR. The levels of P-selectin and smoking are the predictors for CLR.
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0.05). In the end of the first year of follow-up, disappearance of FVPC was significantly less in control group (37.8%) than that in treatment group (60.0%), P
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AIM: To investigate the effect of L-arginine (L-Arg) on intimal proliferation and expression of related cell cycle regulatory factors after vascular injury in rats. METHODS: Rats were divided into three groups :sham operation group, balloon injury group(this group included balloon 48 h,7 d and 14 d subgroup) and balloon+L-Arg group. Neointima area were calculated morphologiocally. The expression of cyclin dependent kinase-2(CDK2),cyclin E and proliferation cell nuclear antigen (PCNA) were measured by means of immunohistochemical technique and computer image analyzer. RESULTS: After vascular balloon injury, the level of plasma NO decreased, CDK2、cyclin E and PCNA expressed in the media at 48 h and in the neointima at 7 d and 14 d but with low and undetected expression in the media, the expression of CDK2, cyclin E and PCNA increased with the intima thickening. Compared with balloon 14 d group, the plasma NO level increased (P＜0.01）, the neointima area reduced by 59.1%(P＜0.01) and the positive expression indexes of CDK2, cyclin E and PCNA decreased by 36.1%, 46.3% and 76.2% respectively in balloon+L-Arg group (P all＜0.01）. CONCLUSION: L-Arg can effectively repress intima proliferation after vascular injury, which may be associated with its inhibiting the proliferation of vascular smooth muscle cell through downregulating the excessive expression of CDK2, cyclin E and PCNA.
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Objective We sought to determine the incidence,clinical features,and risk factors for retroperitoneal hematoma(RPH)after percutaneous coronary intervention(PCI).Methods A retrospective analysis yielded 21 cases of RPH out of 3,729 consecutive patients undergoing PCI between January 2000 and September 2005 in Anzhen hospital.Cases were compared with a randomly selected sample of 30 control subjects without RPH.Predictors were studied using univariate and multivariate analysis.Results The incidence of RPH was 0.6%.Anemia(100%)was a most universal feature.Features of RPH included hypotension(95%),diaphoresis(57%),groin pain(48%),abdominal pain(38%)and back pain(38%).The following variables were found to be independent predictors of RPH:female gender(odds ratio OR=5.23,P
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Objective To investigate the changes of apoptosis and expression of related apoptosis regulatory factors in neointima after canine coronary angioplasty Methods Stents were implanted in the left circumflex coronary artery in 15 canines Arteries were harvested at 1, 4, and 12 weeks after stenting Uninjured arteries were used as controls Apoptosis was demonstrated by the terminal uridine nick end labeling (TUNEL) method and transmission electron microscopy Proliferating cells were identified by immunostaining for proliferating cell nuclear antigen (PCNA) Expressions of Bcl xl proteins were detected by immunohistochemical method and Western blot Results Stents implantment induced intimal hyperplasia Apoptosis was not detected in control vessels Apoptotic cells and PCNA positive cells were identified at 1, 4, and 12 weeks with a peak at 1 week Profiles of apoptosis and cell proliferation after stenting were accordant in neointima, but cell proliferation rates were higher than cell apoptosis rates at all time points Expressions of Bcl-xl proteins were detected at 1 week, peaked at 4 weeks, and lasted till 12 weeks after stenting Conclusion Apoptosis may be an important determinant of in stent restenosis Bcl xl appears to play a critical role in regulating cell apoptosis
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Objective To determine whether the anti-proliferation effect of L-arginine is due to inhibiting the expression of cyclin dependent kinase-2 (CDK2)、 CyclinE and proliferation cell nuclear antigen (PCNA) in blood vessel after balloon injury. Methods Rats were randomized into three groups: Group S (sham operation group), Group C (balloon injury control group) and Group L (balloon injury + L-arginine group). After 14 days, blood samples were collected for biochemical studies, and the thoracic aortas were harvested for immunohistochemistry. The expression of CDK2、 CyclinE and PCNA were measured by means of computer image analayzer. Results The levels of plasma nitric oxide (NO) in group C were significantly lower than those in group S. Compared with group C, the levels of plasma NO increased (P