Evaluation of Curcumin (Turmeric Extract) Effect on Prevention of CIN in Patient Under Elective Coronary Angiography, a Randomized Double Blind Placebocontrolled Clinical Trial.

INTRODUCTION: Curcumin is turmeric extract that have antiproliferative, anti-cancer, and anti-oxidant effects and has been shown that it may have reno-protective properties. This study conducted to evaluate the efficacy of curcumin in the prevention of CIN. METHODS: This randomized placebo-controlled clinical trial was carried out on 138 patients with chronic stable angina scheduled for elective coronary angiography that had renal insufficiency. Patients were randomized to receive curcumin or placebo in addition to standard hydration with saline 0.9% before nonionic iso-osmolar contrast agent administration for angiography. Serum creatinine was measured 12h before, 24h and 48h after contrast injection. CIN, mainly, defined as increase in creatinine of ≥ 0.5 mg/dL or ≥ 25% from the baseline. RESULTS: Serum creatinine change was 0.19 ± 0.31 mg/dL which was 0.22 ± 0.33 and 0.16 ± 0.29 in placebo and curcumin group, respectively. In 'repeated measure analysis' no statistically difference was found in serum creatinine level between pre-intervention, and 24 hours and 48 hours after intervention. CIN was occurred less frequently, though statistically insignificant, in curcumin group (22.7%) compared with placebo group (32.3%). CONCLUSION: It was found that although curcumin reduced the incidence of CIN, this difference was not statistically significant. It seems that, like other antioxidant substances studied in previous studies, although curcumin can reduce apoptosis and oxidative stress at cellular level, but in high risk patients for CIN, such as patients with renal insufficiency, it does not produce more protective effects than hydration with normal saline.

Co-culture of Platelets with Monocytes Induced M2 Macrophage Polarization and Formation of Foam Cells: Shedding Light on the Crucial Role of Platelets in Monocyte Differentiation

Objective: Far beyond hemostasis and thrombosis, significant evidence has indicated the critical role of platelets in atherosclerosis. SDF-1 is among the pro-inflammatory chemokines that are increased in platelets of patients with coronary artery disease (CAD). The goal of the current work is to identify the in vitro effect of platelets from either CAD patients or healthy volunteers on the induction of macrophages and foam cells. Materials and Methods: The expression of SDF-1 on platelet surfaces in CAD patients and healthy volunteers was investigated using flow cytometry. We also evaluated the CXCR4/CXCR7 expression on monocytes from buffy coats of healthy volunteers. The effect of platelets from CAD patients and healthy volunteers on differentiation of monocytes and foam cell formation was evaluated using Oil Red O (ORO) staining. Flow cytometry and real-time PCR were also employed to evaluate surface markers and mRNA expression of genes involved in this process after co-culture of platelets with monocytes. Results: Monocytes in co-culture with platelets acquired a spindleshape appearance and ORO-positive lipid droplets. In addition, platelets could induce CD163 expression, as an important marker of M2 macrophage, and upregulate the mRNA expression of the SRB, CD36, ACAT, LXR-α, and ABCA1 genes in monocytes. Notably, platelets of CAD patients with higher expression of SDF-1, increased the expression of genes encoding SRB and CD36 as compared to platelets of healthy volunteers. Conclusion: Our results indicate that platelets from CAD patients could provoke monocyte differentiation into macrophages with an M2 phenotype, which in turn may participate in an atheroprotective process.

Value of exercise tolerance testing in evaluation of diabetic patients presented with atypical chest discomfort.

BACKGROUND: Coronary artery disease is the single most important cause of mortality and morbidity in diabetic patients. Electrocardiographic stress test is a non-invasive modality to screen significant coronary involvement in minimally symptomatic diabetics. OBJECTIVES: We investigated the Positive Predictive Value (PPV) of this test in comparison with coronary angiography. MATERIALS AND METHODS: 130 diabetic patients with atypical chest discomfort were studied and tested using Exercise Tolerance Test (ETT) among which 100 cases showed positive results that further were studied invasively by selective coronary angiography. RESULTS: The positive predictive value of ETT for diagnosis of Coronary Artery Disease (CAD)among diabetic patients presented with atypical chest discomfort was 77%. CONCLUSION: We conclude that electrocardiographic stress test is a valuable inexpensive non-invasive screening test in diabetic patients with atypical chest discomfort.