Autoantibodies to oxidized low density lipoprotein in relation with coronary artery disease.

The relationship between autoantibodies (autoAbs) to oxidized LDL (oxLDL) and coronary artery disease (CAD) remains controversial. IgM and IgG autoAbs to oxLDL and 1-palmitoyl-2 (5'-oxo-valeroyl)-sn-glycero-3-phosphorylcholine (POVPC), as well as the levels of non modified or modified ApoB-100 immune complexes (ICs), were measured in twenty patients undergoing clinically indicated coronary angiography, and in ten young healthy volunteer sera. The levels of IgM autoAbs to oxLDL did not differ between no CAD patients and healthy subjects, but the levels of these autoAbs were significantly higher in no CAD patients and healthy subjects in comparison with CAD patients. There was not difference in the levels of IgM anti-ApoB-100 ICs between both groups of patients. In contrast, the levels of ICs formed by IgM autoAbs and oxidative modified ApoB-100 were lower in patients with CAD than in patients without CAD. No differences were observed in the levels of autoAbs to POVPC among the groups. In conclusion, our results showed that the level of circulating oxLDL IgM autoAbs was lower in CAD patients than in no CAD patients, supporting the hypothesis that this kind of autoAbs might be inversely associated with the presence of atherosclerosis.

Resultados clínicos iniciais do primeiro stent de cromo-cobalto concebido no Brasil / Initial clinical results of the first cobalt-chromium stent designed in Brazil

FUNDAMENTOS: Os stents de cromo-cobalto são constituídos de hastes mais finas, apresentando maior flexibilidade e, possivelmente, menor proliferação neointimal que os stents de aço inoxidável. MÉTODO: O registro do stent Cronus (Scitech Produtos Médicos, Goiânia, GO) é um estudo prospectivo, não-randomizado, internacional, desenhado para avaliar a eficácia e a segurança do novo stent de cromo-cobalto de hastes finas em pacientes com insuficiência coronária. No total, 69 lesões foram tratadas em 53 pacientes envolvidos nessa análise. RESULTADOS: Foi constatado sucesso do dispositivo em 98,5% dos casos. A perda luminal tardia foi de 0,7 ± 0,5 mm, tendo ocorrido reestenose binária em 15% e revascularização do vasoalvo em 11,3% dos casos. A incidência de eventos cardíacos adversos maiores (morte, infarto do miocárdio ou revascularização do vaso-alvo) foi de 24,4% após 317 ± 80 dias de acompanhamento. CONCLUSÃO: Nossos resultados iniciais demonstram que o novo stent Cronus mostrou-se seguro e eficaz, com resultados clínicos semelhantes aos observados em outros stents de hastes finas.

BACKGROUND: Thin-strut cobalt-chromium stents have greater flexibility and probably have less neointimal proliferation than stainless steel stents. METHOD: The Cronus (Scitech Produtos Médicos, Goiânia, Brazil) registry is an international, non-randomized, prospective study designed to evaluate the efficacy and safety of a novel thin-strut cobalt-chromium stent in patients with coronary artery disease. A total of 69 lesions were treated in 53 patients included in this analysis. RESULTS: The device success was 98.5%. Mean late luminal loss was 0.7 ± 0.5 mm, binary restenosis occurred in 15% and target vessel revascularization in 11.3% of the cases. The incidence of major adverse cardiac events (death, myocardial infarction or target vessel revascularization) was 24.4% after 317 ± 80 days of follow-up. CONCLUSION: Our initial results demonstrate that the novel Cronus stent proved to be safe and effective, with clinical results similar to other available thin-strut stents.

Latin American randomized trial of balloon angioplasty vs coronary stenting for small vessels (LASMAL): immediate and long-term results.

PURPOSE: To assess the potential role of coronary stent to improved acute success and reduce late restenosis in lesions with reference diameter <2.9 mm using a bare metal stent specifically designed for small coronary vessels. There is controversy on the results among previous studies comparing bare metal stent implantation with conventional balloon percutaneous transluminal coronary angioplasty (PTCA). Differences in baseline characteristics, inclusion and exclusion criteria, and stent design may account for these discrepancies. METHODS: The population of this multicenter, multinational randomized study (LASMAL) consisted of 246 patients undergoing percutaneous coronary intervention of small vessel reference diameter. They were randomized into 2 strategies of percutaneous revascularization: elective primary stent (n = 124) or conventional balloon PTCA with provisional stenting (n = 122) in the presence of acute, threatened closure or flow-limiting dissections. RESULTS: The clinical success rate was significantly better for the stent group (98.3% vs 91.8%; P = 0.038). At 30 days follow-up, requirements of target vessel revascularization (TVR) (6.6% vs 0.8%; P = 0.018) and incidence of major adverse cardiac and cerebrovascular events (MACCE) (9.8% vs 2.4%; P = 0.01) was significantly lower in the stent strategy. Postpercutaneous coronary intervention minimal luminal diameter (MLD) was significantly larger in the stent group (2.3 +/- 0.2 mm vs 2.2 +/- 0.2 mm; P = 0.003). At follow-up, MLD in the stent group was larger than with PTCA (1.7 +/- 0.7 mm vs 1.5 +/- 0.7 mm, respectively; P = 0.035). Net gain was also significantly better with stent strategy (1.1 +/- 0.7 mm vs 0.8 +/- 0.7 mm, respectively; P = 0.002). Stenting resulted in a significant lower angiographic binary restenosis (20% vs 31%; P = 0.02) than PTCA. Furthermore, patients treated with stent were more frequently free from MACCE at 9-month follow-up (death, acute myocardial infarction [AMI], stroke, repeat revascularization procedures) than those treated initially with PTCA (82.2% vs 72% of PTCA, P = 0.046). CONCLUSIONS: The use of a specifically designed bare metal coronary phosphoril choline-coated stent as primary device during percutaneous interventions in small coronary arteries was associated with high procedural success and low in-hospital and 30-day follow-up complications. At long-term follow-up, patients initially treated with stents had lower angiographic restenosis rate and were more frequently free from major adverse cardiac events.

Equivalencia terapéutica de atenolol. relación entre la liberación y el efecto clínico esperado / Therapeutic equivalency of atenolol: relationship between release and clinical expected effect

De acuerdo con el enfoque sistémico de la Biofarmacia, el efecto clínico de un medicamento se evalúa por la relación de ganancia establecida desde la liberación del fármaco, mediando su distribución farmacocinética, hasta el efecto clínico observado. De ahí que el actual criterio para valorar la efectividad de iguales medicementos pero de diferente procedencia de manufactura, sea el integrar la correspondencia de diversos factores que determinarán su respuesta clínica. A los efectos de establecer la posible biequivalencia del atenolol genérico de producción nacional, se estudia su comportamiento frente a otro producto de marca registrada, el innovador. Se realizaron ensayos para determinar su perfil de disolución, tanto como la mediciones de nivel sanguíneo del fármaco durante el régimen de dosificación, hasta alcanzar el estado estacionario. Las muestras sanguíneas se colectaron a intervalos preestablecidos para analiza los criterios farmacocinéticos en 12 pacientes hipertensos (AU)

Equivalencia terapéutica de atenolol: relación entre la liberación y el efecto clínico esperado / Therapeutic equivalency of atenolol: relationship between release and clinical expected effect

De acuerdo con el enfoque sistémico de la Biofarmacia, el efecto clínico de un medicamento se evalúa por la relación de ganancia establecida desde la liberación del fármaco, mediando su distribución farmacocinética, hasta el efecto clínico observado. De ahí que el actual criterio para valorar la efectividad de iguales medicementos pero de diferente procedencia de manufactura, sea el integrar la correspondencia de diversos factores que determinarán su respuesta clínica. A los efectos de establecer la posible biequivalencia del atenolol genérico de producción nacional, se estudia su comportamiento frente a otro producto de marca registrada, el innovador. Se realizaron ensayos para determinar su perfil de disolución, tanto como la mediciones de nivel sanguíneo del fármaco durante el régimen de dosificación, hasta alcanzar el estado estacionario. Las muestras sanguíneas se colectaron a intervalos preestablecidos para analiza los criterios farmacocinéticos en 12 pacientes hipertensos