Myeloproliferative neoplasms and coronary artery disease / 中国实用内科杂志

Myeloproliferative neoplasms(MPN) are high risk factors of atherosclerosis and arterial thromboembolism. This article gives a review on the incidence, pathogenesis, clinical features and treatment of MPN with coronary artery disease, emphasizing the importance of knowing MPN as possible causes of acute cardiovascular events in patients, in order to help clinicians to learn about the disease and make a proper diagnosis and treatment.

The Impact of High Sensitivity C-Reactive Protein Level on Coronary Artery Spasm as Assessed by Intracoronary Acetylcholine Provocation Test

PURPOSE: High sensitive C-reactive protein (hs CRP) is well known as a strong risk factor of cardiovascular disease (CVD). The aim of this study is to evaluate the impact of elevated hs CRP on coronary artery spasm (CAS) as assessed by intracoronary acetylcholine (ACh) provocation test. MATERIALS AND METHODS: A total of 1729 consecutive patients without significant CVD who underwent coronary angiography and intracoronary ACh test between November 2004 and August 2010 were analyzed. The patients were divided into five groups according to quintiles of hs CRP levels. RESULTS: At baseline, the prevalence of elderly, hypertension, diabetes mellitus, current smoking, and lipid levels were higher in patients with higher hs CRP. During ACh test, the incidences of significant CAS, ischemic electrocardiography (EKG) change, multivessel, and diffuse CAS were higher in patients with higher hs CRP. Multivariate analysis showed that the old age (OR=1.01, CI; 1.0-1.02, p=0.0226), myocardial bridge (OR=3.34, CI; 2.16-5.17, p<0.001), and highest quintile hs CRP (OR=1.54, CI; 1.12-2.18, p=0.008) were independent predictors of ACh induced CAS. However, there was no difference in clinical outcomes up to 12 months. CONCLUSION: In conclusion, higher hs CRP was associated with higher incidence of CAS, worse angiographic characteristics and ischemic EKG change, but was not associated with clinical outcomes.

Impact of Heterogeneous Overlapping Drug-Eluting Stents on the Arterial Responses of Rabbit Iliac Arteries: A Comparison With Overlapping Bare Metal Stents

BACKGROUND AND OBJECTIVES: Although the use of heterogeneous overlapping drug-eluting stents (DES) is not uncommon in clinical practice, whether the implantation sequences of heterogeneous DES will influence the endothelialization or arterial responses differently remains unclear. MATERIALS AND METHODS: Twenty-one rabbits were randomized to receive overlapping stents in the iliac artery for 3 months {distal sirolimus-eluting stent (SES, Cypher(TM))+proximal paclitaxel-eluting stent (PES, Taxus(TM)) (C+T, n=7), distal Taxus+proximal Cypher (T+C, n=7) and bare metal stent (BMS)+BMS (B+B, n=7)}. Endothelial function was evaluated by the acetylcholine provocation test during follow-up angiography. Histopathological changes in proximal, overlapped, and distal stented segments were evaluated. RESULTS: Although the overall angiographic outcomes were comparable, late loss (mm) in the distal stented segment was higher in the B+B (0.39+/-0.07) and C+T (0.40+/-0.20) than that in the T+C (0.06+/-0.02) group (p<0.001). The incidence of acetylcholine-induced spasm was higher in the DES groups compared with BMS, regardless of the implantation sequences (85.7% in C+T vs. 14.3% in B+B vs. 71.4% in T+C, p=0.017). Notably, only the distal Cypher implantation group (C+T) had three cases of stent fracture. A histopathological analysis showed that despite similar arterial injury scores, Taxus and Cypher stents had higher inflammatory reactions at the overlapped and distal segments compared with those of BMS. CONCLUSION: Despite similar arterial injury, higher inflammatory reactions were observed in overlapping DES segments regardless of the implantation sequence compared with that of BMS. Moreover, DES was associated with impaired endothelial function on the adjacent non-stented segments.

Effects of supplementing qi and activating blood circulation method on platelet aggregation rate, adhesion rate and thromboxane B2 level in patients with stable angina pectoris and intolerable to aspirin / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effects of supplementing qi and activating blood circulation method (YQHX) on platelet aggregation rate (PAgR), platelet adhesion rate (PAdR) and thromboxane B2(TXB2) level in patients with stable angina pectoris and intolerable to aspirin.</p><p><b>METHODS</b>Seventy-six out-patients with stable angina (qi deficiency and blood stasis syndrom) pectoris intolerable to aspirin were randomized into two groups, 40 in the treated group and 36 in the control group. Both received conventional Western medicinal treatment with YQHX to the treated group additionally, for 1 month. PAgR, PAdR, TXB2 level, platelet count, hemoglobin concentration and fecal occult blood were measured before and 1 month after treatment, and the cardiac events as well as diges tive symptoms occurred in the observation period were recorded.</p><p><b>RESULTS</b>PAgR, PAdR and TXB2 level lowered in the treated group after 1-month treatment showed a significant difference to those of baseline, and also to those in the control group (all P <0.01). But no significant difference was found between pre-treatment and post-treatment, also between the two groups in platelet count, hemoglobin concentration, fecal figure and incidence of adverse cardiac events, as well as digestive symptoms (P > 0.05).</p><p><b>CONCLUSION</b>YQHX can effectively inhibit the platelet function in patients with stable angina pectoris without aggravation of digestive symptoms. Cardiac event reducing effect of YQHX was not seen in this study, it is necessary for large sampled study for confirmation.</p>