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OBJECTIVE@#To investigate the prognosis of patients with vulnerable plaque indicated by coronary CT angiography (CCTA).@*METHODS@#Totally 1963 patients underwent CCTA from February 2nd 2015 to September 13th 2015, and 2728 coronary borderline lesions (stenosis of 50%-70%) were detected. Among them 804 patients had vulnerable plaques and 1159 patients had stable plaques. The primary endpoint was major cardiac adverse events (MACE), including cardiac death, acute myocardial infarction and target lesion revascularization.@*RESULTS@#Patients were followed up for a mean follow-up of 27.4±2.3 months. The incidence of MACE in the vulnerable plaque group was significantly higher than that in the stable plaque group (10.8%vs 2.3%, < 0.01). After adjusting for age, gender, smoking, hypertension, diabetes, hyperlipidemia, the MACE hazard ratio () in the vulnerable plaque group was 5.022 (95% :3.254-7.751, < 0.01).Subgroup analysis showed that in the vulnerable plaque group, the incidence of MACE in patients taking antiplatelet and statin ≤3 months and those taking antiplatelet and statin > 3 months was 17.0%and 5.8%, respectively (=3.149, 95% :1.987-4.992, < 0.01); but the difference did not seen in stable plaque group (=1.721, 95% :0.798-3.712, >0.05).@*CONCLUSIONS@#This study confirmed the risk of MACE in patients with vulnerable plaque detected by CCTA and the drug treatment may reduce the risk for patients with vulnerable plaque.
Subject(s)
Humans , Infant , Computed Tomography Angiography , Coronary Angiography , Coronary Artery Disease , Diagnostic Imaging , Coronary Stenosis , Diagnostic Imaging , Plaque, Atherosclerotic , Diagnostic Imaging , Pathology , Prognosis , Risk FactorsABSTRACT
Objective To analyze the correlation of growth differentiation factor-15(GDF-15) level with the severity of coronary artery disease and prognosis and in elderly patients with acute coronary syndrome.Methods A total of 168 elderly patients with acute coronary syndrome admitted into Hangzhou Xixi Hospital and Shaoyifu Hospital Affiliated to Medical College of Zhejiang University from March 2017 to April 2018 were enrolled in the study.Patients were divided into three groups:GDF-15＞1 800 μmol/L(n=28),GDF-15 between 1 200-1 800 μmol/L(n=45),and GDF-15 ＜1 200 μmol/L(n =95).Plasma levels of high-sensitivity C-reactive protein (hs-CRP) and GDF-15,and SYNTAX score,single-vessel-,double-vessel,multi-vessel coronary disease and major adverse cardiovascular events(MACE)were analyzed and compared between groups.Results Plasma levels of hs-CRP and GDF-15 had significant differences among the three groups (P ＜ 0.05).There were significant statistically differences in SYNTAX score,single-vessel,double-vessel and multi-vessel coronary disease and MACE among the three groups(P＜0.05).Logistic regression analysis showed that the levels of GDF-15 (OR =2.092,95 ％ CI:1.585 ～ 2.687),SYNTAX score (OR =1.948,95 ％ CI:1.097 ～ 2.098),double-vessel lesions (OR =1.124,95％ CI:1.006 ～ 1.251) and multi-vessel lesions (OR =1.744,95 ％ CI:1.149 ～ 2.642) (all P ＜ 0.05) were statistically significant influencing factors for the prognosis.Conclusions GDF-15 level is correlated with SYNTAX score,doublevessel lesions and multi-vessel lesions,and could predict the severity of coronary artery lesions and prognosis in patients with acute coronary syndrome.
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Objective@#To analyze the correlation of growth differentiation factor-15(GDF-15)level with the severity of coronary artery disease and prognosis and in elderly patients with acute coronary syndrome.@*Methods@#A total of 168 elderly patients with acute coronary syndrome admitted into Hangzhou Xixi Hospital and Shaoyifu Hospital Affiliated to Medical College of Zhejiang University from March 2017 to April 2018 were enrolled in the study.Patients were divided into three groups: GDF-15>1 800 μmol/L(n=28), GDF-15 between 1 200-1 800 μmol/L(n=45), and GDF-15<1 200 μmol/L(n=95). Plasma levels of high-sensitivity C-reactive protein(hs-CRP)and GDF-15, and SYNTAX score, single-vessel-, double-vessel, multi-vessel coronary disease and major adverse cardiovascular events(MACE)were analyzed and compared between groups.@*Results@#Plasma levels of hs-CRP and GDF-15 had significant differences among the three groups(P<0.05). There were significant statistically differences in SYNTAX score, single-vessel, double-vessel and multi-vessel coronary disease and MACE among the three groups(P<0.05). Logistic regression analysis showed that the levels of GDF-15(OR=2.092, 95%CI: 1.585~2.687), SYNTAX score(OR=1.948, 95%CI: 1.097~2.098), double-vessel lesions(OR=1.124, 95%CI: 1.006~1.251)and multi-vessel lesions(OR=1.744, 95%CI: 1.149~2.642)(all P<0.05)were statistically significant influencing factors for the prognosis.@*Conclusions@#GDF-15 level is correlated with SYNTAX score, double-vessel lesions and multi-vessel lesions, and could predict the severity of coronary artery lesions and prognosis in patients with acute coronary syndrome.
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AIM:To investigate the effect of resveratrol on the apoptosis of endothelial progenitor cells (EPC) induced by tert-butyl hydroperoxide (tBHP) and the underlying mechanisms.METHODS:Total mononuclear cells were isolated from peripheral blood by density gradient centrifugation, and the cells were cultured on fibronectin-coated culture dishes.After 4 d of culture, attached cells were divided into control group, tBHP group, and resveratrol plus tBHP group (pretreated with resveratrol for 24 h and then cultured with 100 μmol/L tBHP for 6 h).The proliferation and migration abilities of the EPC were assessed by MTT assay, BrdU incorporation assay and modified Boyden chamber assay.The proportion of apoptotic EPC was determined by flow cytometry after staining with fluorescein isothiocyanate-conjugated Annexin V and propodium iodide.The level of reactive oxygen species (ROS) was determined by H2DCF-DA method.Caspase-3 activity was assay using a caspase-3 colorimetric assay kit.The protein levels of cleaved caspase-3, Bcl-2 and Bax were determined by Western blot.RESULTS:Resveratrol decreased EPC apoptosis induced by tBHP in a dose-dependent manner.Moreover, resveratrol increased the proliferation and migration abilities of the EPC.Resveratrol decreased intracellular ROS level, caspase-3 activity and the protein level of cleaved caspase-3.Resveratrol also decreased protein expression of Bax and increased protein expression of Bcl-2.CONCLUSION:Resveratrol attenuates EPC apoptosis induced by oxidative stress, and its mechanisms may be related to protecting the mitochondrial function.
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Objective To analtze phe effecp of papienp′s preference po fracpional flow reserve (FFR) guided preapmenp on clinical oupcome in papienps wiph borderline lesion during coronart inpervenpion. Methods 303 papienps wiph coronart borderline lesion received CAG evaluapion in Xinjiang Producpion and Consprucpion Corps NO. 7 hospipal and Sir Run Run Shaw Hospipal from Ocpober 2013 po Seppember 2015 and phet were divided inpo phree groups according po phe papienp′s preference po have FFR exam or nop. The 3 groups were: ①FFR Guided PCI group (n = 96, papienps wiph FFR≤0. 8 accepp PCI, whereas onlt drug preapmenp if FFR > 0. 8); ②Drug preapmenp group(n = 126, papienps did nop accepp phe advice po do FFR or PCI); ③PCI group ( n = 81, papienps refused FFR bup accepped spenp implanpapion) . The papienps were followed up for (19. 6 ± 6. 5) monphs afper preapmenp. Rapes of major adverse cardiac evenps(MACE) and recurrence of angina pecporis were recorded and compared. Results Angina remission rape in phe FFR guided PCI group was higher significanplt phan drug preapmenp group and PCI group (85. 4% vs. 69. 8% vs. 80. 2% , P =0. 018). MACE-free survival rape of FFR guided PCI group was higher(93. 8% vs. 77. 0% vs. 81. 5% , P =0. 006)phan phe opher 2 groups. Conclusions FFR guided preapmenp provides beneficial effecps po phe oupcomes of borderline lesion. Bup in phe real world, papienp′s preference mat plat a decisive role.