Prognostic Value of Coronary Microvascular Dysfunction Assessed by Coronary Angiography-Derived Index of Microcirculatory Resistance in Patients With ST-Segment Elevation Myocardial Infarction.

BACKGROUND: CaIMR is proposed as a novel angiographic index designed to assess microcirculation without the need for pressure wires or hyperemic agents. We aimed to investigate the impact of caIMR on predicting clinical outcomes in STEMI patients. METHODS: One hundred and forty patients with STEMI who received PCI in Putuo Hospital of Shanghai from October 2021 to September 2022 were categorized into CMD and non-CMD groups according to the caIMR value. The baseline information, patient-related examinations, and the occurrence of MACE at the 12-month follow-up were collected to investigate risk factors in patients with STEMI. RESULTS: We divided 140 patients with STEMI enrolled into two groups according to caIMR results, including 61 patients diagnosed with CMD and 79 patients diagnosed with non-CMD. A total of 21 MACE occurred during the 1 year of follow-up. Compared with non-CMD group, patients with CMD showed a significantly higher risk of MACE. A multivariate Cox regression model was conducted for the patients, and it was found thatcaIMR was a significant predictor of prognosis in STEMI patients (HR: 8.921). Patients with CMD were divided into culprit vascular CMD and non-culprit vascular CMD, and the result found that culprit vascular CMD was associated with the incidence of MACE (OR: 4.75) and heart failure (OR: 7.50). CONCLUSION: CaIMR is a strong predictor of clinical outcomes and can provide an objective risk stratification for patients with STEMI. There is a strong correlation among leukocyte index, the use of furosemide, Killips classification, and clinical outcomes.

Effects of chitosan and PC-chitosan-coated membranes on growth and hemocompatibility of vascular endothelial cells / 第二军医大学学报

Objective: To investigate the effects of chitosan (CHI) and PC-chitosan (PC CHI) coated membranes on the proliferation, migration, and hemocompatibility of vascular endothelial cells. Methods: CHI and PC-CHI were separately sprayed on the bottom of culture dish evenly to form the polymer membrane; the cylinder was made of 316 L stainless steel flake. Pig iliac endothelial cells (PIEC) were cultured on the polymer membranes, the stainless steel bottom of the cylinder, and the untreated bottom of culture dish (as blank control). Then the cell morphology was observed by light microscope and scan electron microscope; cell proliferation was measured by Cell Counting Kit-8 (CCK 8); and cell migration was also assayed. Whole blood activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FiB), and thrombin time (TT) were examined by clotting method. Results: PIEC grew well on the membranes of CHI and PC-CHI, with normal morphology. After 24 h culture, the proliferation rates of PIEC were 88. 8% and 77. 8% on CHI and PC-CHI membranes, respectively. The survived PIEC on CHI and PC-CHI membranes were significantly more than those on 316 L stainless steel flake(P<0.01), and those on CHI membrane were significantly more than those on PC-CHI membrane(P<0.01). After 72 h culture, the numbers of migration cells on CHI and PC-CHI membranes were significantly more than those on 316 L stainless steel flake(P<0.01), and those on PC-CHI membrane were significantly more than those on CHI membrane(P<0.01). APTT in PC-CHI, 316 L stainless steel flake, and blank control groups were significantly longer than that of CHI group(P<0.01, P<0.05), and FiB levels in the former 3 groups were higher than that of CHI group(P<0.01). Conclusion: Coating with CHI and PC-CHI can improve the proliferation and migration of vascular endothelial cells on the culture dishes, indicating an excellent biocompatibility of CHI and PC-CHI membranes. PCPCH membrane has more potent antithrombotic effect than CHI does.

Comparison of effects between China made sirolimus-eluting stents and bare stents for treating patients with acute myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the clinical outcomes between China made sirolimus-eluting stents (SES) and bare metal stents (BMS) implantation in patients with acute myocardial infarction (AMI).</p><p><b>METHODS</b>Consecutive patients with AMI underwent primary percutaneous coronary intervention (PCI) were randomly divided into SES group (n = 87) and BMS group (n = 86). The incidence of major adverse cardiac events (MACE including death, reinfarction, in-stent thrombosis, restenosis rate, target vessel revascularization) up to 6 months post PCI were assessed.</p><p><b>RESULTS</b>Postprocedure vessel patency, enzymatic release, cardiac function, and the incidence of short-term MACE were similar between the two groups (all P > 0.05). Two in-stent thrombosis was diagnosed in the SES group and bare stents group respectively (2.4% vs. 2.3%, P > 0.05). At 6 months, In-stent restenosis rate (4.5% vs. 40.0%, P < 0.01) and the in-segment restenosis rate (6.8% vs. 44.9%, P < 0.01) as well as MACE (8.0% vs. 24.4%, P < 0.01), which is mainly due to a marked reduction in the risk of target vessel revascularization (3.4% vs. 11.6%, P < 0.05) were significantly lower in SES group compared to BMS group.</p><p><b>CONCLUSION</b>The China made SES were not associated with an increased risk of in-stent thrombosis but significantly reduced restenosis rate and MACE at 6 months post primary angioplasty in patients with AMI.</p>