Association between serum cartilage oligomeric matrix protein and coronary artery calcification in maintenance hemodialysis patients.

BACKGROUND: Coronary artery calcification (CAC) is common in end-stage renal disease (ESRD) patients, and the extent of CAC is closely related to cardiovascular outcomes in ESRD patients. Cartilage oligomeric matrix protein (COMP), as a component of the vascular matrix, has been found to be an inhibitor of arterial calcification in basic studies. However, there is no clinical research on the correlation between COMP and CAC in maintenance hemodialysis (MHD) patients. The aim of this study was to explore the relationship between serum COMP levels and CAC and cardiovascular events in MHD patients. METHODS: Serum COMP levels were compared between 54 MHD patients and 66 healthy people. MHD patients were then divided into three groups according to the tertiles of the concentration of COMP level and were followed up for major adverse cardiac events (MACEs), which were defined as a combined end point of new onset angina pectoris, nonfatal myocardial infarction, heart failure, coronary artery revascularization, hospitalization due to angina pectoris and all-cause deaths. The CAC score was calculated based on computed tomography scans. RESULTS: The serum COMP level in MHD patients was significantly higher than that in the general population [984.23 (248.43-1902.61) ng/mL vs. 219.01 (97.26-821.92) ng/mL, P < 0.01]. Serum COMP levels were positively correlated with CAC (r = 0.313, P = 0.021) and serum parathyroid hormone in MHD patients (r = 0.359, P < 0.01). Linear regression suggested that after adjusting for age, fasting blood glucose (Glu) and glycosylated hemoglobin (HbAlc), CAC score was an independent predictor in the final model for COMP level (ß = 0.424, t = 3.130, P < 0.01). The receiver operating characteristic (ROC) curve showed that COMP ≥ 994 mg/mL had 68.0% sensitivity and 72.4% specificity for the prediction of severe CAC [area under the curve (AUC): 0.674, P = 0.030, 95% CI: 0.526-0.882]. After a median follow-up of 16 months (8-24 months), there was no difference in the incidence rate of MACEs between the upper, middle and lower serum COMP groups. CONCLUSIONS: Our study found that MHD patients have higher levels of circulating COMP than controls. The serum COMP level is positively correlated with CAC score and could be used as a biomarker of severe CAC in MHD patients. However, there is no obvious correlation between serum COMP levels and the incidence of cardiovascular events.

A Possible Allergic Reaction Case to Thrombin Injected into Pseudoaneurysm After Radiofrequency Ablation.

BACKGROUND Radiofrequency ablation is a minimally invasive treatment for arrhythmias, including frequent ventricular premature. As a complication of radiofrequency ablation, pseudoaneurysm can be treated conservatively or by ultrasound-guided thrombin injection. CASE REPORT We report a case that a possible allergic reaction to thrombin injected into pseudoaneurysm after radiofrequency ablation. CONCLUSIONS We hope that the report of successful management of the allergic reaction in this case may be of help to other doctors; we also emphasize the importance of checking the patient's history of allergies to thrombin when considering treating pseudoaneurysm with thrombin injection.

Altered serum level of cartilage oligomeric matrix protein and its association with coronary calcification in patients with coronary heart disease.

BACKGROUND: Cartilage oligomeric matrix protein (COMP) is mainly found in the skeletal system and vascular smooth muscle cells. Recent researches showed that it had a protective function on blood vessels and could also inhibit vascular calcification. We investigated the serum COMPs in coronary heart disease (CHD) patients, and the relationship between serum COMP and the calcification of coronary artery. METHODS: A total of 233 consecutive chest pain patients who first underwent coronary angiography followed by multi-slice computed tomography (MSCT) within six months were recruited and divided into two groups according to the coronary angiography luminal diameter narrowing percentages: CHD group (diameter narrowing ≥ 50%, n = 194) and control group (diameter narrowing < 50%, n = 39). The Gensini score, Syntax score and coronary artery calcium score (CACs) were calculated. The serum COMP level was determined using ELISA. RESULTS: The levels of COMP were significantly higher in the CHD group than in the control group 155.7 (124.5-194.5) ng/mL vs. 128.4 (113.0-159.9) ng/mL, P = 0.019. There were no correlation between COMP, Gensini score, Syntax score, severity of coronary stenosis and the number of coronary artery with stenosis > 50%. The serum COMP was correlated with age (r = 0.294, P < 0.001), fasting glucose (r = 0.163, P = 0.015), HbA1c (r = 0.194, P = 0.015) and CACs (r = 0.137, P = 0.037). Stepwise linear regression analysis showed that COMP level and age were independent predictors of CACs in the CHD patients (ß = 0.402, t = 2.612, P = 0.015; ß = 0.472, t = 3.077, P = 0.005). Performance of COMP for predicting CHD was shown as area under curve (AUC): 0.632, 95% CI: 0.549-0.715 and upper tertile CACs was AUC: 0.602, 95% CI: 0.526-0.678 in receiver operating characteristic (ROC) curve analysis. CONCLUSION: Calcification of coronary artery was an independent predictor of serum COMPs.