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1.
Clin Biochem ; 125: 110729, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38342398

ABSTRACT

BACKGROUND: Proprotein convertase subtilisin/kexin type 9 (PCSK-9) is a circulating protein that plays an important role in lipid metabolism and is linked to inflammation, which has implications for atherosclerosis and its severe cardiac effects. We studied the potential association of the PCSK-9 gene single nucleotide polymorphism (SNP), Oxidized low-density lipoprotein receptor 1- (OLR-1), and caspase-3 serum levels with the risk and severity of premature coronary artery disease (PCAD). The potential contribution of PCSK-9 serum level to the severity of PCAD patients was also assessed. METHOD: This case-control study included 120 PCAD patients (age < 45), and 60 age matched healthy controls. Serum PCSK-9 and caspase-3 levels and clinical characteristics were recorded. SYNTAX score was calculated to estimate the severity of the coronary artery lesions. The SNP rs2483205 of the PCSK-9 gene and the rs11053646 of the OLR-1gene were genotyped in all participants. RESULTS: Serum PCSK-9 levels were higher in PCAD patients and were significantly different among the three SYNTAX score groups (SS ≤ 12, 12 < SS ≤ 21.5, and SS > 21.5). The diagnostic cutoff values of PCSK-9 and caspase-3 levels for PCAD were > 3.2 ng/mL for both, yielding an area under the curve (AUC) of 0.98 and 0.92, sensitivity of 85 %, 98 %, and specificity of 99.5 %, 93 % for PCSK-9 and caspase-3, respectively. The genotypes TT + CT vs. CC of PCSK-9's rs2483205 SNP presented a higher risk for PCAD and higher SYNTAX scores. Furthermore, the rs11053646 SNP of OLR-1 presented the CG genotype as more risky and having higher SYNTAX scores. CONCLUSION: Circulating PCSK9 and caspase-3 concentrations were higher in PCAD patients and were associated with CAD severity. The SNPs of PCSK-9 (rs2483205) and OLR-1 (rs11053646) were associated with PCAD and its severity.


Subject(s)
Coronary Artery Disease , Humans , Proprotein Convertase 9/genetics , Caspase 3 , Case-Control Studies
2.
Curr Probl Cardiol ; 49(1 Pt A): 102035, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37586446

ABSTRACT

Coronary artery disease remains a significant health problem, especially in developing countries. Adherence to guideline-directed therapy improves the quality of care. In this study we assessed adherence to quality indicators (QIs) for ST-elevation myocardial infarction (STEMI) management in our center as an example from a developing country. Our study included 870 STEMI patients who were admitted to our center (Assiut University Heart Hospital, Egypt) and eligible for primary percutaneous coronary intervention during the period from January 2022 to December 2022. Fifteen QIs were studied. The results show that our center is closely adherent to STEMI management guidelines. However, the most important gaps were related to time delays. The mean of first medical contact (FMC) to electrocardiogram (ECG) time was 13.2 ± 16.1 minutes and arrival time to ECG time was 12.8 ± 3.9 minutes. The mean of FMC to device time for total patients was 61.2 ± 42.8 minutes. However, that for patients transferred from non-PCI capable center was 108.2 ± 63.5 minutes compared to patients presented directly to our center (mean arrival time to a device was around Mean 49.6 ± 22.5 minutes). This resulted in only 77% of patients having FMC to device time < 90 minutes. Regarding guideline-directed medical therapy, we are adherent by more than 90%. In-hospital mortality was 1.1%. So we conclued that many centers in developing countries are closely adherent to QIs of STEMI management. However, there are still some limitations including delays in transportation, a limited number of primary PCI centers, absence of a well-established network of communication between centers, and financial issues.


Subject(s)
Percutaneous Coronary Intervention , ST Elevation Myocardial Infarction , Humans , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/therapy , Egypt/epidemiology , Quality Indicators, Health Care , Hospitalization
3.
Asian Cardiovasc Thorac Ann ; 30(9): 985-991, 2022 Nov.
Article in English | MEDLINE | ID: mdl-36112800

ABSTRACT

BACKGROUND: Although there is a trend toward direct transcatheter aortic valve implantation (TAVI), still balloon predilatation is necessary in some cases, especially in patients with severe calcification. However, predilatation including rapid ventricular pacing may have adverse outcomes, especially in patients with reduced ejection factor (EF). OBJECTIVE: To evaluate the impact of predilatation on in-hospital outcomes in patients with reduced versus preserved EF underwent TAVI. METHODS: This was a prospective observational study including 110 patients (72 patients with preserved EF (≥50%) and 38 patients with reduced EF (<50%)) who underwent TAVI. The two groups were compared regarding in-hospital outcomes. RESULTS: Predilatation was done routinely in all 110 patients. The mean age was significantly higher in patients with preserved EF (82.76 ± 5.74 vs. 80.13 ± 6.51 years; p = 0.03). The majority (51.4%) of patients with preserved EF were females but the majority (73.7%) of those with reduced EF were males (P < 0.001). Predilatation showed no statistical difference regarding in-hospital mortality (2.6% vs. 1.4%; p = 0.29), hemodynamic instability (5.3% vs. 0.0%; p = 0.11), stroke (0% vs. 1.4%; p = 0.67), conduction defects (13.2% vs. 19.4%; p = 0.29), permanent pacemaker implantation (7.9% vs. 5.5%; p = 0.45), paravalvular leakage (5.3% vs. 2.8%; p = 0.42), vascular complications (7.9% vs. 11.1%; p = 0.43), and acute kidney injury (7.9% vs. 7%; p = 0.4) in patients with reduced versus preserved EF, respectively. CONCLUSION: When balloon predilatation is inevitable during TAVI it is safe in patients with reduced as well as preserved EF with no added risk of hemodynamic instability or other outcomes.


Subject(s)
Aortic Valve Stenosis , Heart Valve Prosthesis , Transcatheter Aortic Valve Replacement , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/etiology , Aortic Valve Stenosis/surgery , Female , Humans , Male , Stroke Volume , Transcatheter Aortic Valve Replacement/adverse effects , Treatment Outcome , Ventricular Function, Left
5.
Appl Biochem Biotechnol ; 194(3): 1193-1205, 2022 Mar.
Article in English | MEDLINE | ID: mdl-34637111

ABSTRACT

cTn and CK-MB are gold standard biomarkers for acute coronary syndrome (ACS) but are less sensitive in the first 3 h after onset of symptoms. A need thus exists for novel biomarkers for early detection of ACS. We evaluated circulating copeptin, miRNA-208, and miRNA-499 as possible biomarkers for early detection of unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI). Sixty-five patients with probable ACS that presented within 4 h of the onset of chest pain (23 UA and 42 NSTEMI) and 25 apparently healthy individuals were studied. Two sets of blood samples collected in the first 3 h and at 6 h after onset were analyzed for copeptin levels via ELISA and miRNA-208 and miRNA-499 expression via real-time PCR. Copeptin, miRNA-208, and miRNA-499 expression levels were significantly increased in UA and NSTEMI patients compared with controls (p < 0.001) and in NSTEMT compared with UA patients (p < 0.001). Levels were also significantly elevated in UA and NSTEMI patients with negative cardiac troponin in the first 3 h (p < 0.001). ROC curves displayed AUC for prediction of ACS of 0.96 for copeptin, 0.97 for miRNA-208, and 0.97 for miRNA-499. Their combination improved AUC to 0.98. Copeptin and miRNA-208 and miRNA-499 expression are promising biomarkers for UA and NSTEMI that present in the first 3 h of pain onset. A combination of these markers with cTn may increase the accuracy of diagnosis by avoiding the gray zone of cTn as a biomarker.


Subject(s)
Glycopeptides
6.
J Healthc Eng ; 2021: 8899263, 2021.
Article in English | MEDLINE | ID: mdl-33815733

ABSTRACT

Software defect prediction (SDP) in the initial period of the software development life cycle (SDLC) remains a critical and important assignment. SDP is essentially studied during few last decades as it leads to assure the quality of software systems. The quick forecast of defective or imperfect artifacts in software development may serve the development team to use the existing assets competently and more effectively to provide extraordinary software products in the given or narrow time. Previously, several canvassers have industrialized models for defect prediction utilizing machine learning (ML) and statistical techniques. ML methods are considered as an operative and operational approach to pinpoint the defective modules, in which moving parts through mining concealed patterns amid software metrics (attributes). ML techniques are also utilized by several researchers on healthcare datasets. This study utilizes different ML techniques software defect prediction using seven broadly used datasets. The ML techniques include the multilayer perceptron (MLP), support vector machine (SVM), decision tree (J48), radial basis function (RBF), random forest (RF), hidden Markov model (HMM), credal decision tree (CDT), K-nearest neighbor (KNN), average one dependency estimator (A1DE), and Naïve Bayes (NB). The performance of each technique is evaluated using different measures, for instance, relative absolute error (RAE), mean absolute error (MAE), root mean squared error (RMSE), root relative squared error (RRSE), recall, and accuracy. The inclusive outcome shows the best performance of RF with 88.32% average accuracy and 2.96 rank value, second-best performance is achieved by SVM with 87.99% average accuracy and 3.83 rank values. Moreover, CDT also shows 87.88% average accuracy and 3.62 rank values, placed on the third position. The comprehensive outcomes of research can be utilized as a reference point for new research in the SDP domain, and therefore, any assertion concerning the enhancement in prediction over any new technique or model can be benchmarked and proved.


Subject(s)
Machine Learning , Software , Bayes Theorem , Delivery of Health Care , Humans , Support Vector Machine
7.
Sensors (Basel) ; 21(5)2021 Mar 08.
Article in English | MEDLINE | ID: mdl-33800227

ABSTRACT

Postquantum cryptography for elevating security against attacks by quantum computers in the Internet of Everything (IoE) is still in its infancy. Most postquantum based cryptosystems have longer keys and signature sizes and require more computations that span several orders of magnitude in energy consumption and computation time, hence the sizes of the keys and signature are considered as another aspect of security by green design. To address these issues, the security solutions should migrate to the advanced and potent methods for protection against quantum attacks and offer energy efficient and faster cryptocomputations. In this context, a novel security framework Lightweight Postquantum ID-based Signature (LPQS) for secure communication in the IoE environment is presented. The proposed LPQS framework incorporates a supersingular isogeny curve to present a digital signature with small key sizes which is quantum-resistant. To reduce the size of the keys, compressed curves are used and the validation of the signature depends on the commutative property of the curves. The unforgeability of LPQS under an adaptively chosen message attack is proved. Security analysis and the experimental validation of LPQS are performed under a realistic software simulation environment to assess its lightweight performance considering embedded nodes. It is evident that the size of keys and the signature of LPQS is smaller than that of existing signature-based postquantum security techniques for IoE. It is robust in the postquantum environment and efficient in terms of energy and computations.

8.
Clin Res Cardiol ; 110(3): 377-381, 2021 Mar.
Article in English | MEDLINE | ID: mdl-32949287

ABSTRACT

OBJECTIVES: To describe and to validate a new technique for crossing stenotic aortic valves (AV). BACKGROUND: Current techniques for crossing the AV may be time-consuming and hazardous. METHODS: One hundred consecutive patients with severe aortic stenosis treated by transfemoral TAVI were prospectively selected to have an initial attempt of 5 min to cross the AV with a novel pigtail/J-wire technique before switching to the conventional Amplatz®/straight wire approach. For the pigtail/J-wire technique, the catheter is placed 3-4 cm above the AV and turned anteriorly in the 30° RAO view. A J-wire pushed out of the pigtail-catheter will reach the anterior wall of the ascending aorta, forming a u-shaped curve above the AV. The height of the pigtail catheter determines the width of the curve, rotation will help to find an orientation, where the vertex of the curved J-wire easily passes the AV. We analyzed the primary success rate within 5 min and the mean crossing time required. RESULTS: Patients were 83.5 ± 5.5 years of age and predominantly male (62%). Primary success rate was 86%, AV crossing took 48.2 ± 34.6 s without complications. Fourteen failed cases were successfully managed with AL1- (6) and both, AL1- and AL2-catheters (8), respectively CONCLUSIONS: The pigtail/J-wire technique for AV crossing is safe, simple and fast. Primary placement of a pigtail catheter into the left ventricle at a success rate of 86% facilitates TAVI procedures.


Subject(s)
Aortic Valve Stenosis/surgery , Aortic Valve/surgery , Heart Valve Prosthesis , Transcatheter Aortic Valve Replacement/methods , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Prospective Studies , Prosthesis Design , Treatment Outcome
9.
Sensors (Basel) ; 20(24)2020 Dec 18.
Article in English | MEDLINE | ID: mdl-33353003

ABSTRACT

In this paper, we propose a non-localization routing protocol for underwater wireless sensor networks (UWSNs), namely, the triangle metric based multi-layered routing protocol (TM2RP). The main idea of the proposed TM2RP is to utilize supernodes along with depth information and residual energy to balance the energy consumption between sensors. Moreover, TM2RP is the first multi-layered and multi-metric pressure routing protocol that considers link quality with residual energy to improve the selection of next forwarding nodes with more reliable and energy-efficient links. The aqua-sim package based on the ns-2 simulator was used to evaluate the performance of the proposed TM2RP. The obtained results were compared to other similar methods such as depth based routing (DBR) and multi-layered routing protocol (MRP). Simulation results showed that the proposed protocol (TM2RP) obtained better outcomes in terms of energy consumption, network lifetime, packet delivery ratio, and end-to-end delay.

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