Effects of remote ischemic post-conditioning on platelet activation of AMI patients.

The recovery of ischemic myocardium blood perfusion is the main treatment option for acute myocardial infarction (AMI). However, this treatment option has multiple side effects that directly affect the quality of life of the patients. The activation of platelet function plays an important role in the occurrence, development and treatment of AMI. The aim of the present study was to analyze the effects of remote ischemic post-conditioning on platelet activation of AMI patients with primary PCI treatment and clinical prognosis. A total of 71 patients with AMI were treated with primary percutaneous coronary intervention (PCI). They were randomly divided into control group (n=34) and observation group (n=37). The patients in the observation group were treated with remote ischemic post-conditioning. Further, flow cytometer was used to detect the platelet alpha granule membrane glycoprotein (CD62P) and the percentages of activated IIb/IIIa (PAC-1). The maximum platelet aggregation rate induced by adenosine diphosphate (ADP) and arachidonic acid (AA) was measured by light transmittance aggrometer. The incidence of major adverse cardiac events (MACE) was compared between the two groups during the follow-up period of 6 months. The percentage of CD62P (24 h after PCI) in the observation group was significantly lower than control group (P<0.05). Further, the incidence of MACE in the observation group was also lower than that of the control group (P<0.05). Remote ischemic post-conditioning could reduce the incidence of MACE in patients with AMI after primary PCI treatment. Moreover, the above observation may be related to the improvement of platelet CD62P activation.

Serum albumin concentrations, effect modifiers and first incident acute myocardial infarction: A cross-sectional study of 1552 cases and 6680 controls.

BACKGROUND: The data regarding low serum albumin (LSA) concentrations as a risk factor of CAD have been inconsistent and previous studies also have not considered the potential presence of multicollinearity among covariates. Additionally, there has been to date no reports about the association of LSA with first incident acute myocardial infarction (AMI) in Chinese Han ethnic population. METHODS: Cross-sectional study of 1552 cases and 6680 controls was performed for identifying the association of LSA with first incident AMI and its possible interactions with risk factors on first incident AMI. RESULTS: On a continuous scale, 1SD (~5 g/l) decrease in serum albumin concentrations was significantly associated with a fully adjusted odds ratio of 1.79, 95% CI (1.54-2.04) for first incident AMI in women, 1.53, (1.41-1.69) in men, and 1.61, (1.49-1.72) in total. On a categorical scale, the association of LSA with risk of first incident AMI was stepwise significantly strengthened with the increased albumin quintiles in age categories in both sexes, without a threshold effect found. A significant interaction was found between LSA and primary hypertension, ischemic stroke and hematocrit on the risk of first incident AMI. CONCLUSIONS: LSA concentrations were significantly associated with first incident AMI in a dose-response manner in age categories in both sexes in Chinese Han ethnic population. Primary hypertension and hematocrit could modify this association. Whether the albumin transfusion for first incident AMI will improve patients' outcome deserves further studies.

A rare long-term survival of the life-threatening trio: silent myocardial infarction complicated by ventricular septal rupture, type 2 diabetes mellitus and chronic bronchitis.

Silent myocardial infarction followed by ventricular septal rupture (VSR) is a rare phenomenon. In the absence of a timely diagnosis and surgical correction, the short term mortality of such patients is greater than 90%. We present one such unique case of a patient with an asymptomatic myocardial infarction complicated by VSR, type 2 diabetes mellitus and chronic bronchitis. Unfortunately, this possibly life-threatening condition had been misdiagnosed for more than one month after initial medical contact. Lack of typical symptoms of chest pain and chronic bronchitis is primarily responsible for this long-time misdiagnosis. We want to emphasize the importance of systematic diagnostic work-up, high vigilance for possibility of VSR complicating myocardial infarction in aged patients with diabetes and chronic bronchitis, which may mislead doctors' judgments and put patients at high risk.

ß-Blockers in heart failure: benefits of ß-blockers according to varying male proportions of study patients.

BACKGROUND: In patients with heart failure (HF), b-blockers reduce mortality. It's not known whether the beneficial effects of the b-blockers were associated with the differing male proportions of study patients. It also remains to be clarified regarding the true beneficial effects of the 3 b-blockers recommended by the guideline on mortality in the real world. HYPOTHESIS: The benefits of b-blockers in HF patients were sex-related different. METHODS: Randomized, placebo controlled clinical trials were included if they evaluated the beneficial effects of the three b-blockers on mortality and on hospital admissions on an intention-to-treat basis, and lasted at least 3 months. RESULTS: Twenty-eighty trials with 14,829 patients were included. The b-blockers significantly reduced all cause mortality by 29.6%, cardiac death by 29.8%, sudden death by 49.4%, respectively. The magnitude of benefits of b-blockers in HF patients was increased with the increased male proportion. A similar magnitude of reduction in all cause mortality was observed among the three b blockers. A trend toward to reduced cardiac death was observed among the three b blockers, but only in bisoprolol was this statistically different (RR, 0.72; 95%CI, [0.59-0.87]). Metoprolol was significantly superior to carvedilol (P = 0.008) or bisoprolol (P = 0.034) in reduced sudden death. CONCLUSIONS: In patients with HF, the 3 commonly used b-blockers significantly reduced mortality. Greater benefits of b-blockers were observed in the higher male proportion studies. The metoprolol was significantly superior to carvedilol or bisoprolol in reduced sudden death. Additional trials are required to determine whether the benefits of b-blockers will be observed in female HF patients.

[Effects of salinity and betaine on BHMT mRNA expression in Lateolabrax japonicus].

Betaine homocysteine methyltransferase (BHMT, EC 2.1.1.5) catalyzes the transfer of a methyl group from betaine to homocysteines (Hcy) to form dimethylglycine and Met, respectively. A full-length cDNA of the BHMT in Lateolabrax japonicus was amplified using RT-PCR and SMART RACE methods. The cDNA of the BHMT in L. japonicus is 1 461 bp in size, with 72 bp 5'-UTR, 183 bp 3'-UTR and 1206 bp ORF, encoding a protein of 401 amino acids with a molecular weight of 44.32 kD and pI 7.21. The sequence analysis indicated that the deduced amino acid sequence of BHMT shared high identity (77%-93%) with nine other species; the highest was 93% with Perca flavescens. Semi-quantitative RT-PCR was used to characterize the expression of BHMT in ten tissues including muscle, heart, eye, brain, gill, liver, intestine, kidney, adipose tissue and spleen. The results showed that BHMT is only expressed in the liver, intestines and kidney. BHMT mRNA in these three tissues declined after the fish were transferred from sea water to a higher salinity environment and induced when transferred to a lower salinity environment. BHMT gene in liver, intestine and kidney can also be induced after intraperitoneal injection of betaine. Our results show that betaine can induce the transcription of BHMT in fish, and BHMT play pivotal roles in adaptation to osmotic change.