ABSTRACT
BACKGROUND: Atherosclerosis is a chronic inflammatory process, and myeloperoxidase (MPO) seems to contribute directly to the pathogenesis of acute coronary syndrome (ACS). OBJECTIVE: To compare MPO levels among the patients with stable and unstable ischemic heart disease and to evaluate their independent prognostic value for cardiovascular events. METHODS: MPO and C-reactive protein (CRP) were assessed in two cohorts of coronary artery disease patients, including 178 patients with stable angina and 130 patients with ACS evaluated at the emergency department. RESULTS: MPO and CRP levels were significantly higher among patients with ACS [MPO 93 (54-127) vs. 9.9 pmol/l (5-21) and high sensitivity-CRP 11 (3-27) vs. 2.6 mg/l (1-5)]. Among patients with stable angina, high sensitivity-CRP levels greater than 3 mg/l were associated with a three-fold risk of further cardiovascular events during a mean follow-up period of 13+/-4 months, although there was no significant association between MPO levels and outcomes. Among patients with ACS, baseline MPO level was an independent predictor of major adverse cardiac events during hospitalization, odds ratio of 3.8 (95% confidence interval: 1.2-12) for the combined endpoint (death, recurrent angina, heart failure, and arrhythmia). CRP levels were associated with hospital mortality in patients with ACS, but were not independently related to cardiovascular events. CONCLUSION: Elevated MPO levels among the ACS patients suggest that this marker may participate in plaque vulnerability and instability process, whereas higher CRP levels were predictive of cardiac events only among the stable angina patients. These findings suggest distinct role of the inflammatory markers studied in the pathophysiology of coronary artery disease.
Subject(s)
Acute Coronary Syndrome/etiology , Angina Pectoris/etiology , Angina, Unstable/etiology , Coronary Artery Disease/enzymology , Inflammation Mediators/blood , Peroxidase/blood , Acute Coronary Syndrome/enzymology , Acute Coronary Syndrome/mortality , Aged , Angina Pectoris/enzymology , Angina Pectoris/mortality , Angina, Unstable/enzymology , Angina, Unstable/mortality , Arrhythmias, Cardiac/enzymology , Arrhythmias, Cardiac/etiology , Biomarkers/blood , C-Reactive Protein/analysis , Chi-Square Distribution , Coronary Artery Disease/complications , Coronary Artery Disease/mortality , Female , Heart Failure/enzymology , Heart Failure/etiology , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Odds Ratio , Prognosis , Proportional Hazards Models , Prospective Studies , Recurrence , Risk Assessment , Risk Factors , Time Factors , Up-RegulationABSTRACT
Com o objetivo de comparar a resistência, tensäo e o padräo histológico de tendöes patelares de animais submetidos à tenotomia e tenorrafia com tendöes näo tenotomizados, 28 ratos Wistar machos (peso médio = 275g) foram submetidos à tenotomia do tendäo patelar esquerdo seguida de tenorrafia. Uma vez divididos em 4 grupos, estes foram sacrificados após 4, 5, 6 ou 8 semanas do procedimento para exérese do tendäo tenotomizado e de seu homólogo direito (utilizado como controle). Após terem sido submetidos ao teste de resistência em um dinamômetro, verificou-se que os tendöes tenotomizados e suturados foram mais resistentes que os controles (p=0,00004). Houve formaçäo de cartilagem e inclusive osso no tecido cicatricial de alguns tendöes.
Subject(s)
Animals , Male , Rats , Wound Healing , Tendon Injuries , Tendons , Muscle Contraction , Prospective Studies , Rats, Wistar , Rupture , Suture Techniques , Tendons/anatomy & histology , Tendons/surgery , Time FactorsABSTRACT
A hiperplasia adrenal congênita é um distúrbio enzimático das supra-renais resultante da deficiência de uma das diversas enzimas necessárias para a biossíntese dos esteróides adrenais a partir do colesterol. A deficiência da enzima 21-hidroxilase é responsável pela grande maioria dos casos. Neste trabalho säo revisadas as características clínicas e laboratoriais , o tratamento e o acompanhamento das crianças com hiperplasia adrenal congênita por deficiência da 21-hidroxilase. Discute-se também a importância do conhecimento das bases genéticas para o diagnóstico e tratamento intra-uterino