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Background: Patients undergoing elective percutaneous coronary intervention (PCI) with drug-eluting stents (DES) who have impaired clopidogrel response, have a higher risk of subsequent major adverse cardiovascular events (MACE)., Aim of the Study: To establish the relationship between CYP2C19 genotype, clopidogrel responsiveness and 1-year MACE., Materials & Methods: Aspirin/clopidogrel responses were assessed with Multiplate Analyzer and CYP2C19*2 allele by SpartanRx., Results: A total of 42.0% carried ≥1 CYP2C19*2 allele. Prevalences of aspirin and clopidogrel high on-treatment platelet reactivity (HPR; local cutoffs: 300 AU*min for aspirin and 600 AU*min for clopidogrel) were 11.5% and 19.8% respectively. In multivariate ana-lysis, clopidogrel HPR was found to be an independent predictor for 1-year MACE (adj HR: 3.48, p = 0.022 )., Conclusion: Having clopidogrel HPR could be a potentially modifiable risk factor guided by phenotyping.

Introduction: Carotid intima media thickness (CIMT) being a cost effective and easily performed technique is useful in the detection of subclinical atherosclerosis and has been shown to be a prognosticator of cardiovascular events. The primary objective of this study was to obtain the distribution of CIMT measurements, highly sensitive C reactive protein (hs-CRP) and assessing health awareness and attitudes of the Malaysian population at cardiovascular disease (CVD) risk and not receiving lipid lowering agents. Secondarily the study sought to assess the significance of the relationship between these measurements against various patient characteristics., Methods: Measurements of CIMT are obtained by ultrasonography of 12 sites within the common carotid artery was recorded for 123 subjects from a single centre tertiary hospital of Malaysia who had two or more CVD risk factors but were not receiving lipid lowering therapy. CVD risk factors and lipid and glucose profiles were analyzed with respect to distribution of CIMT and high-sensitivity Creactive protein (hs-CRP) values., Results: The mean-max CIMT was 0.916±0.129mm (minimum 0.630mm, maximum 1.28mm) and the mean-mean CIMT was 0.743±0.110mm (minimum 0.482mm, maximum 1.050mm) and mean hs-CRP was 0.191mg/dL (minimum 0.030mg/dL, maximum 5.440mg/dL). Multivariate analyses confirmed a significant association between increasing CIMT and increasing age, total and low density lipoprotein cholesterol while log-transformed hs-CRP levels showed significant association with increasing body mass index, waist circumference, high blood glucose and triglyceride levels. Our patients had good health awareness on CVD., Conclusion: Newly defined CIMT measurements and hs-CRP levels may be useful adjunctive tools to screen for atherosclerosis in the Malaysian population. It may help in refining risk stratification on top of traditional clinical assessment.

Organofunctionalized apatite nanoparticles were prepared using a one step process involving dissolution/precipitation of natural phosphate rock and covalent grafting of nitrilotris(methylene)triphosphonate (NTP). The synthesized materials were characterized by Brunauer-Emmett-Teller (BET) surface measurement, thermogravimetry, inductively coupled plasma emission spectroscopy (ICP-ES), elemental analysis, multinuclear solid state cross-polarization/magic angle spinning (CP/MAS) and single-pulse NMR spectroscopy, transmission electron microscopy (TEM) and energy dispersive x-ray analysis (EDXA). After grafting BET measurements yielded particle specific surface areas ranging from 88 to 193 m(2) g(-1) depending on the grafted phosphonate. The results show that the surfaces of the nanoapatite particles can be covered with functional groups bound through a variable number of R-P-O-Ca bonds to render them organoapatites.

A natural phosphate rock and two synthetic mesoporous hydroxyapatites were evaluated for the removal of pyridine and phenol from aqueous solutions. Experiments performed by the batch method showed that the sorption process occurs by a first order reaction for both pyridine and phenol. In contrast, the Freundlich model was able to describe sorption isotherms for phenol but not for pyridine. In parallel, the three apatites exhibit similar pyridine sorption capacities whereas phenol loading was in agreement with their respective specific surface area. This was attributed to the strong interaction arising between pyridine and apatite surface that hinders further inter-particular diffusion. This study suggests that, despite its low specific surface area, natural phosphate rock may be used as an efficient sorbent material for specific organic pollutants, with comparable efficiency and lower processing costs than some activated carbons., (Copyright 2010 Elsevier B.V. All rights reserved.)