简介：ObjectivesToevaluatethechangesoftheplasmaendothelinlevelinpatientswithdilatedcardiomyopathy,andtoinvestigatetherelationshipbetweentheplasmaendothelinlevelandtheseverityofheartfailure,heartsize,leftventricularfunctionandwithornotwithpulmonaryarterialhypertension;thechangesoftheplasmaendothelinlevelbeforeandaftertreatment.MethodsTheplasmaendothelinlevelof30patientswithDCM,30healthycontrolsubjects,andtheirLVEF,PAP,heartsize,plasmaendothelinlevelbeforeandaftertreatmentweredetermined.ResultsTheplasmaendothelinlevelinDCMgroupwassignificantlyhigherthanthatincontrolgroup(135.93±70.65pg/mL)vs(43.65±12.07pg/mL),P<0.05;therewasacorrelationbetweenETlevelandheartsize(r=0.4580,P=0.0109);therewasasignificantnegativecorrelationbetweenLVEFofDCMandETlevel(r=-0.6922,P=0.0021);anditwasasignificantpositivecorrelationbetweenETlevelandpulmonaryarterialhypertension(r=0.8974,P<0.0005).Aftertreatment,theETleveldecreasedsignificantlythanbeforeinDCMgroup(129.15±43.93pg/mL)vs(63.12±22.20pg/mL),P<0.05.ConclusionsPlasmaETlevelmaybeanewparameterofevaluatingseverityofheartfailure,efficacyoftherapyandprognosis.

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简介：BackgroundIncreasedserumleveloflipoprotein(a)(Lp(a))isassociatedwithatherosclerosis.WhetherincreasedLp(a)levelisindependentlyassociatedwiththeseverityofcoronaryarterydisease(CAD)isunclear.MethodsSubjectswereenrolledandreceivedcoronaryangiographytoassessthenumberofstenosedcoronaryartery.ThesubjectswithCADweredividedintonon-significant(<50%stenosis),singleandmultivesselstenosis(≥50%stenosis)groups.Parametersofinterestatbaselinewerecollected.StatisticalanalyseswereperformedtoevaluatetherelationshipbetweenLp(a)levelandCADseverity.ResultsTotally745populationswereenrolledanddiagnosedasCAD(n=605)orwithoutCAD(n=140)onthebasisofangiographyexamination.AscomparedtothesubjectswithoutCAD,serumlevelsofLp(a)andCRP,andthepercentagesofsubjectswithsmokingordiabetesweresignificantlyhigherinsubjectswithCAD.Incontrast,serumlevelsofHDL-CandApo-AweresignificantlylowerinsubjectswithCADascomparedtosubjectswithoutCAD.Incomparisonofsubjectswithnon-significantstenosis(serumLp(a)level,170.0±19.7mg/dL),serumLp(a)levelwassignificantlyhigherinsubjectswithsingle(245.5±22.3mg/dL)ormultiplevesselstenoses(265.8±14.0mg/dL).Withmultivariateregressionanalyses,afteradjustedforage,gender,smoking,familyhistoryandhypertension,therewasstillsignificantassociationbetweenserumLp(a)levelandthenumberofcoronaryarterystenosis.Afteradditionaladjustmentfordiabetes,HbA1c,totalcholesterol,LDL-C,Apo-A,uricacidandCRP,Lp(a)remainedstronglyassociatedwithCADseverity.ConclusionSerumLp(a)levelwassignificantlyassociatedwiththeseverityofcoronaryarterystenosis,whichmayaddthevalueoncardiovascularriskevaluation.

简介：BackgroundIncreasedlevelofglycatedhemoglobin(HbA1c)isassociatedwithhigherincidenceofcoronaryarterydisease(CAD)inthediabetics.However,therelationshipbetweenHbA1candtheriskofcoronaryarterystenosisinthenon-diabeticsiscontroversial.MethodsAretrospectiveresearchwasconductedon338enrolledparticipantswhohaveundergone2timesofcoronaryangiographicexaminationwithinthepastyear.Clinicalandlaboratoryvariablesattheinitialandthesecondtimeofadmissionwerecollected.AccordingtotheinitialmedianHbA1clevel,allparticipantsweredividedintotwogroupsnamedlowerandhighergroups.TherelationshipbetweenHbA1clevelandtheriskofcoronaryarterystenosisovertimewasevaluated.ResultsTheinitialvaluesofHbA1cinloweranduppergroupswere5.78±0.35%and6.21±0.32%(P<0.05).Ascomparedtothelowergroup,thepercentagesofmaleandsmokingparticipants,andtheserumlevelofCRPweresignificantlyhigherinthehighergroup(P<0.05).Othertraditionalriskfactorswerecomparablebetweenthetwogroups.Therewere54.2%and55.2%participantswithsinglevesselstenosis,and45.8%and44.8%withmultiplevesselstenoses,respectivelyinthetwogroupswithoutsignificantdifference.Thesecondtimeofadmission,were308.5±25.4days(lowergroup)and300.7±30.1days(highergroup)fromtheinitialadmission.AlthoughnosignificantchangesofHbA1clevelwereobservedwhencomparedtoinitial,HbA1clevelinthehighergroupwasstillsignificantlyhigherincomparisontothelowergroup(6.24±0.39%vs.5.80±0.36%,P=0.008).Thepercentageofnewcoronaryarterystenosis(≥50%stenosis)washigherinthehighergroupthanthatinthelowergroup(41.7%vs.32.3%,P<0.001).MultivariateregressionanalysessuggestedthatHbA1cremainedindependentfactorassociatedwithcoronaryarterystenosesafterextensiveadjustmentforriskfactors.ConclusionInthenondiabetics,increasedbaselineHbA1clevelportendstheriskofcorona

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简介：Repeatcoronaryrevascularizations(RCR)arecommoninpatientsunderwentpercutaneouscoronaryintervention.ThereisnoavailablepredictionmodelforRCRatpresent.Theassociationbetweenparaoxonas-1(PON1)andthedevelopment,progression,andprognosisofcoronaryarterydiseaseisunderhotresearch.Therela-tionshipofserumPON1activitylevelandRCRhasnotbeenreported.ThisresearchaimedtodetectthedifferenceofserumPON1activitylevelsbetweenRCRandsinglecoronaryrevascularization(SCR),hencetoilluminatethevalueofPON1inpredictingRCR.MethodsSerumPON1activitylevelsof200patientswhohadachievedcompleterevascu-larizationsinfirstpercutaneouscoronaryintervention(PCI)weredeterminedbycolorimetricmethod.Allpatientsre-ceivedone-yearfollow-up.Coronaryangiographieswereperformedat6thmonth.Patientswhoneedmorerevasculariza-tionprocedureduringfollow-upwereenrolledinRCRgroup;thosewhodidnotneedmorerevascularizationprocedurewereenrolledinSCRgroup.Onehundredpatientswithnormalcoronaryangiographyduringthesameperiodweresetupasnon-coronaryheartdiseasecontrolgroup(NCC).ResultsSixtytwopatientswereenrolledinRCRgroup(28within-stentrestenosis,34withlesionprogressioninothercoronarysegments).SerumPON1activitylevelsinRCRgroup,SCRgroupandNCCgroupwere109.2±98.6μkat/L,132.8±79.4μkat/Land156.4±82.8μkat/L,respective-ly.Statisticdifferenceswerefoundamongthreegroups(P<0.05).ConclusionsSerumPON1activitylevelsarelowerinpatientswhoneedrepeatcoronaryrevascularizationsthaninpatientsneedsinglepercutaneouscoronaryinter-ventionorwithoutcoronaryheartdisease.AlowerserumPON1activityleveliscloselyassociatedtorepeatcoronaryre-vascularization.

简介：ObjectivesToob-servetheeffectofdifferentestrogenlevelsonthesecretoryfunctionofvascularendothelialcellsoffemalerats,andstudytheeffectofmodulationofestrogenlevelontheexpressionofvascularcelladhesionmolecule-1andtheconcentrationofestrogenreceptorinvascularendothelialcells.MethodsRadioim-munologywasusedtomeasuretheserumconcentrationofendothelinandPGI2,andcopper-cadmiumreductionwasemployedtomeasuretheserumcontentofnitrogenmonoxide.Radioligandbindingandflowcy-tometrywereusedtomeasuretheexpressionofestrogenreceptorandvascularcelladhesionmolecule(VCAM-1)ofvascularendothelialcellsrespectively.Results1.TheserumconcentrationofnitricoxideandPGI2decreasedwhentheovariesoffemaleratswereremoved.Inovariectomizedrats,givenestrogen,theconcentrationrose(P<0.05),buttheplasmaconcentrationofendothelinwasadversetoit.2.Theconcentrationofestrogenreceptorofvascularendothelialcel

简介：BackgroundIncreasedplasmalevelofLp-PLA2isapotentialriskfactorforatherosclerosis.Nevertheless,whetherLp-PLA2haseffectsonbothvascularfunctionandstructurechangesisstillunclear.MethodOnehundredandeighty-sixoutpatientsubjectswithoutovertcardiovasculardiseasewereenrolledandanthropometricdata,plasmalevelofLp-PLA2andotherrelatedlaboratoryparameterswerecollected.Measurementsofpulsewavevelocity(PWV)andcarotidintima-mediathickness(CIMT)wereperformedbyanexperiencedinvestigator.AccordingtoplasmalevelofLp-PLA2,allthesubjectsweredividedintotwogroupsasfollows:<200ng/mL(n=96)and≥200ng/mL(n=90).ResultBodymassindex,smoking,diabeticmellitus,systolicbloodpressure,andLDL-ClevelwerepositivecorrelationwithplasmalevelofLp-PLA2,whileuseofstatinswasnegativelycorrelative.BothPWVandCIMTpositivelycorrelatedwithsmoking,systolicbloodpressure,LDL-ClevelandplasmalevelofLp-PLA2,whilenegativelycorrelatedwithHDL-Clevelandusageofstatins.CIMTinthegroupwithplasmalevelofLp-PLA2<200ng/mL(0.9±0.2mm,n=96)wassignificantlylessthanthatwithplasmalevelofLp-PLA2≥200ng/mL(1.2±0.4mm,n=90,P=0.32),andsimilarfindingwasalsoobservedinPWV(9.1±0.5m/svs12.7±0.4m/s,P=0.38).ConclusionOurpresentstudyshowsthatinsubjectswithoutovertCVD,increasedplasmalevelofLp-PLA2isassociatedwithvascularfunction(PWV)andstructure(CIMT)deterioration.

简介：ObjectivesToinvestigatetheeffectofsimvastatinontheprobabilityofrestenosisafterstentimplantationandserumleveloflipidsaswellashigh-sensitivityC-reactiveprotein(hs-CRP)inpatientswithcoronaryheartdisease(CHD).Methods118patientswithCHDafterstentingtherapyweredividedintotreatmentgroup(n=62)andcontrolgroup(n=56)randomly.Allpatientsweretreatedwithaspirin(100mg/d)andclopidogrel(75mg/d)whiletreatmentgrouppatientstooksimvastatin(40mgqn)additionally.Allpatientsunderwentcoronaryangiography(CAG)tocomparethedifferenceofrestenosisandtheserumleveloftotalcholesterol(TC),low-densitylipoproteincholesterol(LDL-c),high-densitylipoproteincholesterol(HDL-c),triglyceride(TG)aswellashs-CRPafterthedrugtreatmentfor6months.ResultsTheprobabilityofrestenosiswassignificantlylowerinthetreatmentgroupthanthatofcontrolgroup(P<0.01)andtheresultsweresimilarbetweenthepatientswithbaremetalstent(P<0.01)andthosewithsirolimus-elutingstent(P<0.01).TheserumlevelsofTC(P<0.01),LDL-c(P<0.01),TG(P<0.05)andhs-CRP(P<0.01)wereobviouslylowerwhiletheHDL-c(P<0.05)levelwashigherinthetreatmentgroupthanthoseofcontrolgroup.Therewasnodeathcase.ConclusionsSimvastatincoulddecreasetheprobabilityofrestenosissignificantlyaftercoronarystentimplantationwithdoseof40mg/d.Italsohasgoodperformanceonlipidscontrolandlighteninginflammatoryreactionswithitsundoubtedlysafety.

简介：BackgroundIntheHORIZONS-AMI(HarmonizingOutcomeswithRevasculariZatiONandStentsinAcuteMyocardialInfarction)trial,3,602patientsundergoingprimarypercutaneouscoronaryintervention(PCI)forST-segmentelevationmyocardialinfarction(STEMI)treatedwithbivalirudinhadlowerbleedingandmortalityrates,buthigheracutestentthrombosisratescomparedwithheparin+aglycoproteinⅡb/Ⅲainhibitor(GPI).SubsequentchangesinprimaryPCI,includingtheuseofpotentP2Y12inhibitors,frequentradialintervention,andpre-hospitalmedicationadministration,wereincorporatedintotheEUROMAX(EuropeanAmbulanceAcuteCoronarySyndromeAngiography)trial,whichassigned2,218patientstobivalirudinversusheparin±GPIbeforeprimaryPCI.ObjectivesThegoalofthisstudywastoexaminetheoutcomesofproceduralanticoagulationwithbivalirudinversusheparin±GPIforprimaryPCI,giventheevolutioninprimaryPCI.MethodsDatabasesfromHORIZONS-AMIandEUROMAXwerepooledforpatient-levelanalysis.TheBreslow-Daytestevaluatedheterogeneitybetweentrials.ResultsAtotalof5,800patientswererandomizedtobivalirudin(n=2,889)orheparin±GPI(n=2,911).Theradialapproachwasusedin21.3%ofpatients,prasugrel/ticagrelorwasusedin18.1%ofpatients,andGPIwasusedin84.8%ofthecontrolgroup.Bivalirudincomparedwithheparin±GPIresultedinreduced30-dayratesofmajorbleeding(4.2%vs.7.8%;relativerisk[RR]:0.53;95%confidenceinterval[CI]:0.43to0.66;P<0.0001),thrombocytopenia(1.4%vs.2.9%,RR:0.48;95%CI:0.33to0.71;P=0.0002),andcardiacmortality(2.0%vs.2.9%;RR:0.70;95%CI:0.50to0.97;P=0.03),withnonsignificantlydifferentratesofreinfarction,ischemia-drivenrevascularization,stroke,andall-causemortality.Bivalirudinresultedinincreasedacute(<24h)stentthrombosisrates(1.2%vs.0.2%;RR:6.04;95%CI:2.55to14.31;P<0.0001),withnonsignificantlydifferentratesofsubacutestentthrombosis.Compositenetadversec