A comparison of the clinical effects and safety between the distal radial artery and the classic radial artery approaches in percutaneous coronary intervention.

BACKGROUND: Compared with a classic wrist puncture for radial artery catheterization, a distal radial artery puncture has the advantage of reducing the incidence of radial artery occlusion in anatomic and physiological procedures. This study aimed to explore the difference in clinical effects between the distal radial artery and classic radial artery approaches in percutaneous coronary intervention. METHODS: A total of 620 patients who underwent coronary angiography and/or percutaneous coronary intervention in our hospital from December 2017 to December 2018 were enrolled in this study. These patients were divided into two groups based on the puncture site: a distal radial artery group and a classic radial artery group. There were 312 patients in the radial artery group and 308 patients in the classic radial artery group. The puncture time, puncture success rate, surgery time, implanted stents, puncture site hemorrhage, hematoma, aneurysm, and iliac artery occlusion rate were observed. RESULTS: There was no significant difference in puncture time, puncture success rate, surgery time, implanted stent, puncture site hemorrhage, hematoma and aneurysm (P>0.05), while the radial artery occlusion rate was lower in the distal radial artery group, and the difference was statistically significant (P<0.05). CONCLUSIONS: The results of this study showed that the distal radial artery approach had a lower rate of brachial artery occlusion, indicating that it could be used as an alternative to the classic radial artery approach.

Suppression of circular RNA circDHCR24 alleviates aortic smooth muscle cell proliferation and migration by targeting miR-149-5p/MMP9 axis.

Circular RNAs (circRNAs) are involved in many courses of atherosclerosis and coronary artery disease (CHD). However, the role and effect of circRNAs in vascular restenosis after PCI remains unclear. Human aortic vascular smooth muscle cell (HA-VSMC) was cultured and stimulated with PDGF-BB. The expression profile of circRNAs in HA-VSMCs was screened using microarray analysis. A total 257 aberrantly expressed circRNAs were screened with 2 fold change. Has_circ_0113656 (also called circDHCR24) was validated by qRT-PCR to be significantly up-regulated in PDGF-BB induced HA-VSMCs. CircDHCR24 silencing obviously inhibited the proliferation, migration and phenotypic switch. Moreover, bioinformatics analysis predicted that miR-149-5p had complementary binding sites in 3'-UTR of circDHCR24. Luciferase reporter assay and RIP assay further verified the circDHCR24 acts as a spong for miR-149-5p in HA-VSMCs. Besides, bioinformatics analysis, luciferase reporter assay and RIP assay proved MMP9 was a directly target of miR-149-5p. Finally, cells were transfected with si-circDHCR24 with or without miR-149 inhibitor, and the results showed that co-transfection si-circDHCR24 and miR-149 inhibitor reversed the effect of si-circDHCR24 on cell proliferation, migration and phenotypic switch. Taken together, our study suggested for the first time that the knockdown of circDHCR24 alleviates HA-VSMCs proliferation, migration and phenotypic switching, thereby preventing vascular restenosis.

Effect of sequential nicorandil on myocardial microcirculation and short-term prognosis in acute myocardial infarction patients undergoing coronary intervention.

BACKGROUND: This study aims to observe the effects of the intracoronary and peripheral venous administration of nicorandil for the postoperative myocardial microcirculation and short-term prognosis of ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI) treatment. METHODS: A total of 140 STEMI patients were divided into three groups according to different patterns of administration: sequential nicorandil group, intracoronary nicorandil group and control group. The main observation indexes included coronary blood flow and myocardial perfusion immediately after PPCI, while the secondary observation indexes included major adverse cardiovascular events (MACE) and left ventricular ejection fraction (LVEF) during the period of hospitalization. RESULTS: After PPCI, the difference in the proportion of patients with thrombolysis in myocardial infarction (TIMI) flow grade 3 among the three groups was statistically significant (P=0.036), where this proportion was higher in the sequential nicorandil group and intracoronary nicorandil group than in the control group (P=0.022 and P=0.047); The difference in corrected TIMI frame count (CTFC) among the three groups was statistically significant (P=0.022), where CTFC was lower in the sequential nicorandil group and intracoronary nicorandil group than in the control group (P=0.010, P=0.031); The differences in the proportion of patients with complete ST resolution (STR) and advancing of enzyme peak time to within 12 h between each two groups were statistically significant (P<0.001), where this proportion was the highest in the sequential nicorandil group; The difference in the CK-MB peak among the three groups was statistically significant (P=0.036), where the CK-MB peak was lower in the sequential nicorandil group than in the control group (P=0.012); The difference in the incidence of MACE between each two groups was statistically significant (P<0.001), where this incidence was the lowest in the sequential nicorandil group; The differences in the proportion of patients with advancing of enzyme peak time to within 14 h and LVEF among the three groups were not statistically significant (P=0.722 and P=0.284). CONCLUSIONS: Compared with intracoronary use alone, the intracoronary and peripheral intravenous use of nicorandil can better improve myocardial microcirculation and short-term prognosis.

Core regulatory RNA molecules identified in articular cartilage stem/progenitor cells during osteoarthritis progression.

Aim: To assess cartilage-derived stem/progenitor cells (CSPCs) in osteoarthritis (OA) by employing mRNA-miRNA-circRNA-lncRNA network biology approach. Methods: Differentially expressed (DE) RNAs in CSPCs from 2-/4-/8-month-old STR/Ort and CBA mice were identified to construct networks via RNA sequencing. Results: Compared with age-matched CBA mice, 4-/8-month-old STR/Ort mice had cartilage lesions and their CSPCs exhibited lower proliferative and differentiation capacity (decreased CD44 and CD90), and identified 7082 DE RNAs in STR/Ort mice were associated with strain differences or OA progression. OA-related core RNAs were identified via the networks constructed with the predominant DE RNAs, which were involved in the signaling pathways (NF-κB/MAPK/Hippo/Wnt/TGF-ß/cytoskeleton organization). The core RNAs (miR-322-5p/miR-493-5p/miR-378c/CPNE1/Cdh2/PRDM16/CTGF/NCAM1) were validated in CSPCs from OA patients. Conclusion: RNA-based networks identifying core RNAs and signaling pathways contribute to CSPC-dependent OA mechanisms.

Added value of contrast echocardiography in characterization of nonischemic cardiomyopathy.

Nonischemic cardiomyopathy (NICM) is a group of noncoronary heterogonous myocardial diseases. The heterogonous nature of NICM has impeded its diagnosis. In the present case series, we demonstrate the added value of using contrast echocardiography in the characterization of NICM. Two patients of advanced age were admitted for possible acute coronary syndrome, which was subsequently excluded by coronary angiography. Conventional and contrast echocardiography revealed characteristic structural and dynamic features of the left ventricle that were compatible with two distinct NICM diseases: stress-induced cardiomyopathy and noncompaction of the ventricular myocardium. Contrast echocardiography characterizes the cardiac structure and allows for real-time assessment of myocardial motion and perfusion. It may help to distinguish diseases with different etiologies.

Ischemic Postconditioning Before Percutaneous Coronary Intervention for Acute ST-Segment Elevation Myocardial Infarction Reduces Contrast-induced Nephropathy and Improves Long-term Prognosis.

BACKGROUND AND AIMS: Contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) is one of the major adverse outcomes affecting the prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI). Ischemic postconditioning prior to PCI (pre-PCI) in patients with STEMI is hypothesized to be protective against CIN after PCI. METHODS: A total of 251 patients with STEMI were randomized into two groups: ischemic postconditioning group (n = 123, age, 61.1 ± 12.5 years) who underwent ischemic postconditioning prior to PCI; control group (n = 128; age, 64.1 ± 12.1 years) who underwent only PCI. Ischemic postconditioning was administered by three cycles of deflation and inflation of the balloon (1-min ischemia and 1-min reperfusion) starting 1 min after infarct-related artery (IRA) opening. Diagnostic criterion for CIN was: increase in serum creatinine level by ≥0.5 mg/dL or by ≥25% increase from preoperative level within 48 h of surgery. All patients were followed for 1 year for incidence of major cardiovascular events (MACE). RESULTS: The incidence of postoperative CIN in the ischemic postconditioning group was 5.69% as compared to 14.06% in the control group (p <0.05). At one year, the MACE incidence in the ischemic postconditioning group was 7.32% as compared to 15.63% in the control group (p <0.05). CONCLUSIONS: Pre-PCI ischemic postconditioning in STEMI patients significantly reduces the post-PCI incidence of CIN and improves long-term prognosis.