Difference of dilation resistance to coronary stenting between fibrous plaques and lipid-rich plaques / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Dilation resistance to stenting in non-calcified coronary plaques was compared in patients with percutaneous coronary intervention (PCI) in order to confirm the clinical usefulness of multislice computed tomography in examining coronary plaque type and to provide information pertaining to the effects of plaque type on dilatation resistance.</p><p><b>METHODS</b>A retrospective analysis of 64-slice computed tomography coronary imaging data collected in the month prior to coronary stenting in 93 patients (65 male and 28 female, mean age of (57.22±7.22) years) was conducted. Non-calcified coronary plaques were divided into lipid-rich (lipid content >25% of plaque volume) and fibrous plaques according to the Hammer-Hansen S method: where lipids, fiber, and intraluminal components were indicated by contrast using Hu values of -100-49, 50-129, and >130, respectively. Clinical features, pre-dilatation balloon specifications and filling pressure, and stent size and release pressure were compared.</p><p><b>RESULTS</b>High-sensitivity C-reactive protein levels were higher in the lipid-rich plaque group. In patients with typical symptoms, unstable angina was more commonly observed in the lipid-rich plaque group. No significant differences in low density lipoprotein, pre-dilatation balloon specifications, pre-dilatation pressure, or stent specifications were observed. Stent release pressure in the lipid-rich plaque group ((1130.16±202.04) kPa), was significantly lower than that observed in the fibrous plaque group ((1240.61±193.29) kPa, P = 0.009).</p><p><b>CONCLUSION</b>Softer, lipid-rich plaques exhibit lower dilation resistance during stenting in PCI patients.</p>

Association between various rs501120 genotypes and progress of unstable coronary atherosclerotic plaque in diabetes mellitus complicated with acute coronary syndrome / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association between single nucleotide polymorphism rs501120 and progress of unstable coronary atherosclerotic plaque in diabetes mellitus complicated with acute coronary syndrome (ACS).</p><p><b>METHODS</b>Nine hundred and two patients with diabetes complicated with acute coronary syndrome were enrolled. The genotype of rs501120 was determined with TaqMan-MGB probes. Two hundred and five cases of TT genotype, 205 age-and sex-frequency-matched cases of TC genotype and 205 age- and sex-frequency-matched cases of CC genotype were chosen and followed up for 3 years. Clinical data and re-occurrences of ACS were recorded.</p><p><b>RESULTS</b>Patients with TT genotype had a significantly higher incidence of recurrence of ACS than those with CC genotype (TT vs. CC: OR 1.7, 95%CI 1.1-2.7, P= 0.02). And the significance has remained even after adjusting for conventional risk factors by logistic regression (OR 1.6, 95% CI1.05-3.6, P= 0.03). Patients with TT genotype had a significantly higher incidence of myocardial infarction than those with CC genotype(TT vs. CC: OR 1.9, 95% CI 1.2-3.2, P= 0.007).</p><p><b>CONCLUSION</b>Our results has suggested an association between the rs501120 polymorphism and progress of unstable coronary atherosclerotic plaque.</p>

Cardioprotective effects of atorvastatin preconditioning via iNOS upregulation in a rabbit ischemia/reperfusion model / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the preconditioning cardioprotection of atorvastatin (ATV) in rabbits underwent 40 min ischemia and 240 min reperfusion and to explore related mechanisms.</p><p><b>METHODS</b>The rabbits were randomized divided into Control group, ATV group (10 mg.kg(-1).d(-1) for 3 days before ischemia), ATV plus iNOS inhibitor S-methylisothiourea sulfate group (ATV + SMT group), SMT group, ATV plus mito K(ATP) channel blocker 5-hydroxydecanoate group (ATV + 5-HD group) and 5-HD group (n = 16 each group). The infarction size, CK-MB, LDH-1, nitric oxide synthase and mitochondrial ATP synthesization capacity ([ATP] m) were determined at the end of reperfusion.</p><p><b>RESULTS</b>Infarction size, CK-MB, LDH-1 were decreased by 26.3%, 31.4%, 19.1% and iNOS, [ATP] m increased by 102.6%, 46.8% post ATV compared to control group (all P < 0.05) and these effects could be blocked by cotreatment with SMT and 5-HD except the iNOS was not affected by 5-HD.</p><p><b>CONCLUSION</b>The atorvastatin preconditioning exerted cardioprotection by upregulating iNOS and activating mito K(ATP).</p>