Usefulness of the SYNTAX score II to predict 1-year outcome in patients with primary percutaneous coronary intervention.

OBJECTIVE: This study aimed to investigate the predictive effect of SYNTAX score II (SS-II) for the 1-year outcome in patients with ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention and whether SS-II improves the ability of anatomical and Logistic Clinical SYNTAX score and Global Registry of Acute Coronary Events to predict major adverse cardiac events (MACE). BACKGROUND: SS-II can predict 1-year outcomes in patients with complex coronary artery disease. However, the prognostic value of SS-II for patients undergoing primary percutaneous coronary intervention remains unclear. MATERIALS AND METHODS: A total of 477 patients were divided into three groups on the basis of SS-II [SS-II low tertile <20 (n=161), 20 ≤SS-II intermediate tertile ≤26 (n=145), and SS-II high tertile >26 (n=171)]. Kaplan-Meier methods were used to compare the MACE at the 1-year follow-up. RESULTS: MACE was highest in the SS-II high tertile (21.1 vs. 10.3 vs. 5.5%, P<0.001), including all-cause mortality (11.7 vs. 4.1 vs. 2.5%, P=0.001), target vessel revascularization (7.6 vs. 4.1 vs. 1.8%, P=0.037), and recurrent MI (5.8 vs. 2.1 vs. 1.2%, P=0.035), compared with SS-II intermediate and low tertiles. In Cox multivariable analysis, SS-II was an independent predictor for MACE at 1 year. The receiver operating characteristic curve showed that SS-II had 60% sensitivity and 78% specificity for predicting 1-year MACE as a cut-off value of 27.5. The respective C-statistics of SS-II, anatomical, and Logistic Clinical SYNTAX score and Global Registry of Acute Coronary Events for MACE were 0.726, 0.587, 0.684, and 0.628 (P<0.05). CONCLUSION: SS-II can predict 1-year clinical outcomes in patients with ST-segment elevation myocardial infarction and has an improved ability to predict MACE.

Short-term rosuvastatin therapy for prevention of contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease.

OBJECTIVES: This study sought to evaluate the safety and efficacy of rosuvastatin in preventing contrast-induced acute kidney injury (CI-AKI) in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). BACKGROUND: CI-AKI is an important complication after contrast medium injection. While small studies have shown positive results with statin therapy, the role of statin therapy in prevention of CI-AKI remains unknown. METHODS: We randomized 2,998 patients with type 2 DM and concomitant CKD who were undergoing coronary/peripheral arterial angiography with or without percutaneous intervention to receive rosuvastatin, 10 mg/day (n = 1,498), for 5 days (2 days before, and 3 days after procedure) or standard-of-care (n = 1,500). Patients' renal function was assessed at baseline, 48 h, and 72 h after exposure to contrast medium. The primary endpoint of the study was the development of CI-AKI, which was defined as an increase in serum creatinine concentration ≥0.5 mg/dl (44.2 µmol/l) or 0.25% above baseline at 72 h after exposure to contrast medium. RESULTS: Patients randomized to the rosuvastatin group had a significantly lower incidence of CI-AKI than controls (2.3% vs. 3.9%, respectively; p = 0.01). During 30 days' follow-up, the rate of worsening heart failure was significantly lower in the patients treated with rosuvastatin than that in the control group (2.6% vs. 4.3%, respectively; p = 0.02). CONCLUSIONS: Rosuvastatin significantly reduced the risk of CI-AKI in patients with DM and CKD undergoing arterial contrast medium injection. (Rosuvastatin Prevent Contrast Induced Acute Kidney Injury in Patients With Diabetes [TRACK-D]; NCT00786136).

One-pot solvothermal synthesis of uniform layer-by-layer self-assembled ultrathin hexagonal Gd2O2S nanoplates and luminescent properties from single doped Eu3+ and codoped Er3+, Yb3+.

Uniform Gd(2)O(2)S flower-like nano-assemblies were prepared through one-pot mild solvothermal synthesis. The parallel nanoplates are the building blocks, ∼3 nm in thickness and 20-30 in diameter. Ethanediamine, the main solvent, plays an important role in dissolving a large amount of sulphur and producing active S(2-) ions, which results in the direct formation of Gd(2)O(2)S. Oleylamine, the capping agent, controls the growth of the plate-like structure. Under UV excitation, the Gd(2)O(2)S:Eu(3+) nano-phosphor shows good red luminescence with a main emission peak at 627 nm. Under 980 nm laser excitation, Gd(2)O(2)S:xYb(3+),1%Er(3+) nano-phosphors exhibit a tuneable emission, shifting from greenish-yellow to orange-yellow, with increasing Yb(3+) content.

Association of mild to moderate kidney dysfunction with coronary artery calcification in patients with suspected coronary artery disease.

OBJECTIVES: To report the association between kidney dysfunction and coronary artery calcification (CAC) score (CACS) among patients with clinically suspected coronary artery disease (CAD). METHODS: We prospectively included 1,572 consecutive patients with clinically suspected CAD who underwent ECG-gated cardiac CT scans using 64-multidetector row computed tomography. CACS was quantified using a previously described method. Renal function was assessed by the estimated glomerular filtration rate (eGFR). Ordinal logistic regression and Pearson correlation were used to analyze the association between eGFR and CACS. RESULTS: Patients with higher CACS were older, more had a history of hypertension, diabetes and tobacco use, and they were more likely to have an atherogenic lipid profile, higher systolic blood pressure, diastolic blood pressure, hemoglobin A1c, body mass index and C-reactive protein (CRP) and lower eGFR when compared with those patients without CAC or with lower CACS. The unadjusted correlation coefficient of eGFR and CACS was -0.259 (p < 0.001). This remained significant after adjustment for age, gender, hypertension, diabetes, hyperlipidemia, tobacco use and CRP (R = -0.156, p < 0.001). Ordinal logistic regression analysis showed that age, hypertension, diabetes, CRP and eGFR exerted independent influences on CACS. CONCLUSIONS: Kidney dysfunction was an independent predictor of CACS in patients with clinically suspected CAD. Further prospective multicenter studies are needed to confirm this finding.