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Background. Previous studies have shown that P2Y12 receptor inhibitors might prevent ventricular arrhythmias and cardiac dysfunction in patients with coronary artery disease. However, few studies have focused on comparison of the efficacy of novel oral potent P2Y12 receptor inhibitors with clopidogrel on these outcomes. Methods and Results. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) that were published in electronic databases of MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, and ClinicalTrials.gov before June 20, 2018. We compared the effect of prasugrel and ticagrelor with clopidogrel on outcomes of ventricular tachycardia (VT), ventricular fibrillation (VF), heart failure (HF), and cardiogenic shock (CS). Data were combined using both the fixed-effects models and the random-effects models, and the heterogeneity was assessed with the I2 statistic. Nine RCTs (6 with prasugrel and 3 with ticagrelor) with 45,227 patients were included. Patients receiving prasugrel were associated with a lower risk of combined VT and VF (rate ratio [RR]: 0.72, 95% confidence interval [CI]: 95% CI: 0.52-0.99, p=0.043), as well as combined HF and CS (RR: 0.81, 95% CI: 0.70-0.94, p=0.005), compared with clopidogrel. Patients receiving ticagrelor were also associated with a reduced risk of VT and VF (RR: 0.85, 95% CI: 0.72-1.02, p=0.077), although without statistical significance, but not of HF and CS (RR: 0.96, 95% CI: 0.81-1.13, p=0.620). Conclusions. This meta-analysis of RCTs shows that, compared with clopidogrel, novel oral P2Y12 inhibitors, especially prasugrel, might have better effect on improving ventricular rhythm and cardiac function. [ABSTRACT FROM AUTHOR]

Summary: Background/Aims: Cardiac rupture (CR) is a catastrophic complication of acute myocardial infarction (MI). At present, there are no effective pharmacological strategies for preventing post‐MI rupture. Here we investigated the effect of trimetazidine (TMZ) on post‐MI CR. Methods: MI models were induced by left coronary artery ligation in male C57BL/6 mice. Animals allocated to the rupture incidence were closely monitored for 7 days; autopsy was performed once animals were found dead to determine the reason of death. Heart function was detected by echocardiography. Oxidative stress markers and matrix metalloproteinases (MMPs) were analyzed by Western Blotting. Results: TMZ markedly reduced the post‐MI CR incidence of mice. We found that the expression of metalloproteinase (MMP) ‐2 and MMP‐9 in the TMZ‐treated group was significantly lower than the saline‐treated group. Further, TMZ markedly attenuated MI‐induced oxidative stress. To investigate the mechanism of the effect of TMZ on CR, we pretreated H9c2 cells with H2O2 and found that TMZ treatment markedly decreased H2O2‐induced MMP‐2 and MMP‐9 expression. TMZ prevents CR through inhibition of oxidative stress, which is attributable to the down‐regulation of MMP‐2, MMP‐9 expression. Conclusions: Our findings indicate that TMZ suppresses oxidative stress, inhibits MMP‐2 and MMP‐9 expression, and prevents CR in mice with MI. [ABSTRACT FROM AUTHOR]

Background. The present study aimed to evaluate the prevalence and prognosis of residual lipid abnormalities in statin-treated acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI). Subjects and Methods. A total of 3,047 ACS patients who underwent PCI and received statin therapy were included. Plasma concentrations of LDL-C, HDL-C, and TG were measured. For the follow-up study, major adverse cardiovascular cerebrovascular events (MACCE; including total death, cardiovascular death, myocardial infarction, and revascularization) were documented. Results. A total of 93.14% of all individuals were followed up for 18.1 months (range, 0–29.3 months). Of all 3,047 patients, those with a suboptimal goal were 67.75%, 85.85%, and 33.64% for LDL-C, HDL-C, and TG levels, respectively. Multiple Cox regression analysis revealed there were significant increases in cumulative MACCE of 41% (HR = 1.41, 95% CI [1.09–1.82], p=0.008), and revascularization of 48% (HR = 1.48, 95% CI [1.10–1.99], p=0.01) in low HDL-C patients with ACS after PCI, but not the high TG group at the end of study. Conclusions. Our results showed there is high rate of dyslipidemia in Chinese ACS patients after PCI. Importantly, low HDL-C but not high TG levels are associated with higher MACCE and revascularization rates in ACS patients after PCI. [ABSTRACT FROM AUTHOR]

Bone marrow mesenchymal stem cells (BMMSCs) are used in cardiac tissue engineering for the regeneration of diseased hearts. We examined the differentiation of rat BMMSCs into cardiomyocyte-like cells when induced with a combined low dose treatment of transforming growth factor-β1 (TGF-β1) and 5-azacytidine (5-AZA). Results showed that cell proliferation in the combined low dose treatment group of TGF-β1 and 5-AZA was increased compared with the TGF-β1 group or the 5-AZA group. The cell apoptosis was relieved by combined TGF-β1 and 5-AZA treatment compared to 5-AZA treatment alone. The number of cells positive for myosin heavy chain, connexin-43, α-actin, and troponin I in the combined treatment group was higher than those observed in the TGF-β1 group or the 5-AZA group. Moreover, the combined low dose treatment group of TGF-β1 and 5-AZA reveals the strongest expression of troponin I, α-actin, and phosphorylated extracellular signal-regulated protein kinases 1 and 2 (p-ErK1/2) among the treatment groups. These results suggest that the combined low dose treatment of TGF-β1 and 5-AZA can improve the differentiation potential of rat BMMSCs into cardiomyocyte-like cells and alleviate cell damage effects in vitro. The mechanism that is involved in influencing differentiation may be associated with p-ErK1/2. [ABSTRACT FROM AUTHOR]

Ultrasound treatment was applied to modify the physicochemical properties of polysaccharides from the seeds of Plantago asiatica L. The initial polysaccharides concentration of 10 mg/mL, ultrasonic power of 800 W, and different treatment time (15 s, 30 s, 1 min, 2 min) were used. After irradiation, the average molecular weight (Mw) and polydispersity index of relative molecular mass (PID) of polysaccharides decreased. The apparent viscosity of degraded polysaccharides dropped compared with native polysaccharides. By using dextran sodium sulphate (DSS) colitis mouse model, enhanced intestinal anti‐inflammatory activity of degraded polysaccharides was proved by a significant reduction in the degree of neutrophil infiltration, indicated by decreased macrophage inflammatory protein‐2 secretion, and levels of inflammatory cytokines (TNF‐α and IL‐4) in inflamed colon. These results suggested that ultrasound treatment is a viable modification technology for high Mw polymer materials with high anti‐inflammatory activity. Practical applications: Ulcerative colitis (UC) is a chronic and nonspecific inflammatory disorder of the colonic mucosa, and assumed to be an autoimmune disease. PLCP was found to be one of the active ingredients responsible for many of the observed bioactivities including anti‐inflammation, anticomplement and facilitating defecation. However, it's extremely complex structure with high molecular weights and high viscosity hampered its applications. In this study, ultrasound irradiation was used to depolymerize PLCP, and its attenuation of intestinal inflammation was also studied. [ABSTRACT FROM AUTHOR]