Subject(s)
Angioplasty, Balloon, Coronary , Angioplasty, Balloon , Vascular Calcification , Humans , Angioplasty, Balloon, Coronary/adverse effects , Angioplasty, Balloon/adverse effects , Renal Dialysis/adverse effects , Treatment Outcome , Vascular Calcification/therapy , Vascular Calcification/surgeryABSTRACT
Hemodialysis (HD) patients tend to have sarcopenia and malnutrition, and both conditions are related to poor prognosis in the cardiovascular disease that often accompanies HD. However, the impact of sarcopenia or malnutrition on the long-term prognosis of HD patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) remains unclear. We analyzed 1,605 consecutive patients with ACS who had undergone PCI at a single center between January 2009 and December 2014. We evaluated all-cause mortality and prognosis-associated factors, including sarcopenia/malnutrition-related factors such as the Geriatric Nutritional Risk Index (GNRI), and Skeletal Muscle Mass Index (SMI). After exclusions, 1461 patients were enrolled, and 58 (4.0%) were on HD. The HD group had lower levels of SMI and GNRI than non-HD group, and had worse in-hospital prognosis. Moreover, HD group had a significant higher mortality in the long-term follow-up [median follow-up period: 1219 days; Hazard Ratio (HR) = 4.09, p < 0.001]. After adjusting the covariates, SMI and GNRI were the factors associated with all-cause mortality in all patients [SMI: adjusted HR (aHR) = 2.39, p = 0.036; GNRI: aHR = 2.21, p = 0.006]; however, these findings were not observed among HD patients with ACS, and only diabetes was significantly associated with all-cause mortality (diabetes: aHR = 3.50, p = 0.031). HD patients with ACS had a significantly higher rate of in-hospital and long-term mortality than non-HD patients. Although sarcopenia and malnutrition were related to mortality and were more common in HD patients, sarcopenia and malnutrition had a lower impact than diabetes on the long-term prognosis of HD patients with ACS.
Subject(s)
Acute Coronary Syndrome , Malnutrition , Percutaneous Coronary Intervention , Sarcopenia , Acute Coronary Syndrome/diagnosis , Acute Coronary Syndrome/etiology , Acute Coronary Syndrome/therapy , Aged , Geriatric Assessment , Humans , Malnutrition/complications , Malnutrition/diagnosis , Malnutrition/epidemiology , Nutrition Assessment , Nutritional Status , Percutaneous Coronary Intervention/adverse effects , Prognosis , Renal Dialysis , Risk Factors , Sarcopenia/complications , Sarcopenia/diagnosis , Sarcopenia/epidemiologyABSTRACT
The non-catalytic conversion of chitin into N-acetyl-á´ -glucosamine (GlcNAc) derivatives such as 2-acetamido-2,3-dideoxy-á´ -erythro-hex-2-enofuranose (Chromogen I) was investigated in high-temperature water at 290-390⯰C and 25â¯MPa with a reaction time of 0-180â¯min. High-temperature water treatment is a promising method for chitin conversion as it does not require the use of any additional organic solvents or ionic liquids. A semi-batch reactor was developed to control the reaction temperature and time. It was found that the chitin powder could be converted into a water-soluble fraction in ~90% yield, with Chromogen I being obtained in a maximum yield of 2.6%. Furthermore, a kinetic model was developed to estimate the reaction rate for the conversion of the chitin powder to the water-soluble fraction.
