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Objectives: This study sought to compare clinical outcomes and angiographic findings using the Resolute zotarolimus-eluting stent (R-ZES) (Medtronic, Santa Rosa, California) versus the Taxus Libert...

AIMS We examined long-term outcomes after implantation of the Resolute zotarolimus-eluting stent (R-ZES) in ST-segment elevation acute myocardial infarction (STEMI) patients. METHODS AND RESULTS We compared long-term outcomes of STEMI patients undergoing primary angioplasty

Atherosclerosis is a complex vascular inflammatory disease. Oxidized low-density lipoprotein (ox-LDL) is directly associated with chronic vascular inflammation. In this study, we hypothesized that nonselective cyclooxygenase inhibitor aspirin might affect the ox-LDL-induced inflammatory responses on human endothelial cells. To test this assumption, cyclooxygenase-2 (COX-2) and intercellular adhesion molecule-1 (ICAM-1) expression, IkappaB and p38 mitogen-activated protein kinase (MAPK) phosphorylation were determined in endothelial cells exposed to ox-LDL in the presence of aspirin. The results showed that aspirin significantly suppressed COX-2 and ICAM-1 expression induced by ox-LDL and also inhibited IkappaB phosphorylation in human umbilical vein endothelial cells (HUVECs). Moreover, aspirin reduced the level of p38 MAPK phosphorylation. Our findings suggest that aspirin can decrease inflammatory responses induced by ox-LDL, and the mechanism might be associated with NF-kappaB activation pathway and inhibition of p38 MAPK phosphorylation.

This study sought to compare clinical outcomes and angiographic findings using the Resolute zotarolimus-eluting stent (R-ZES) (Medtronic, Santa Rosa, California) versus the Taxus Liberte paclitaxel-eluting stent (PES) (Boston Scientific, Natick, Massachusetts) in an all-comer Chinese population.Concerns regarding restenosis risk led to new-generation drug-eluting stents (DES) designed for use in patients with complex clinical or lesion characteristics. In-stent late lumen loss (LLL) is a measure of restenosis risk.Patients with an indication for treatment with a DES were randomized in a 1:1 ratio to placement of at least 1 R-ZES or PES with minimal exclusions. The primary endpoint was angiographic in-stent LLL at 9 months post-procedure. Clinical endpoints at 12 months are compared between the 2 stents.A total of 198 patients received a R-ZES, and 202 patients received a PES. Most patients were male; 25.8% and 29.2% of R-ZES and PES patients, respectively, had diabetes. Over 70% of lesions in both cohorts were American College of Cardiology/American Heart Association lesion classification Type B2 and C (B2/C). In-stent LLL was 0.16 ± 0.38 mm for R-ZES and 0.33 ± 0.52 mm for PES at 9 months (p0.001; 95% confidence interval [CI]: -0.26 to -0.08). The rates of clinically driven target lesion revascularization were 1.5% for R-ZES and 7.0% for PES (p = 0.011). The rate of target lesion failure was 5.6% for R-ZES and 11% for PES (p = 0.068).In an all-comers Chinese population, 9-month in-stent LLL was significantly less with R-ZES compared with PES, which was reflected in lower revascularization rates at 12 months for the R-ZES patients. Results are consistent with previous clinical trials of the R-ZES in all-comer populations. (Resolute Zotarolimus-Eluting Stent Versus the Taxus Liberte Paclitaxel-Eluting Stent for Percutaneous Coronary Intervention in China [R-China RCT]; NCT01334268).

Objective: To find the prevention of restenosis after transluminal angioplasty (TA).Methods: Sixty rabbit iliac arteries of 30 rabbits were randomly divided into three groups: group A, B and C, 20 in each. After experimental atherosclerotic stenosis and TA performing, ordinary forage plus 2 g of Hirudo (Hirudo nipponica whitmania) powder was fed to group A every day, to the group B, 2 gSalvia miltiorrhiza (red sage root) powder was added and to the group C, ordinary forage only. Angiography and pathomorphological examination were carried out 30 days later.Results: (1) Hirudo significantly reduced the thickness of iliac intima as compared with the other two groups (P < 0.05), the thickness in the group A, B and C was 40.1 ± 9.8 μm, 48.2 ± 8. 2 μm and 69. 3 ± 9. 2 μm respectively. (2) The incidence of restenosis after TA in both group A (31.4%) and group B (48.4%)were significantly lower than that in the group C (62.8%,P < 0.05). The difference was also found between the group A and B(P < 0.05). (3) Ultrastructure examined by transmission electron microscopy showed that less rough endoplasmic reticulum and more myofilaments in well differentiated smooth muscle cell (SMC) of the arterial intima in the group A and B, while in the group C, more rough endoplasmic reticulum, more synthetic cells were seen in SMC.Conclusions: Hirudo andSalvia miltiorrhiza could effectively inhibit the hyperplasia of SMC in arterial intima and reduce intima thickness and the incidence of restenosis after TA significantly, thus it might play a role in the prevention of restenosis after TA. The effect of Hirudo is more potent than that ofSalvia miltiorrhiza.

To determine whether the extent of prolongation of the transisthmus interval after ablation predicts complete bidirectional block.Since 1996 to 2002, 30 consecutive patients underwent ablation procedures for isthmus-dependent atrial flutter. There were 23 males and 7 females [mean age (47.85 +/- 9.35) years]. With the use of fluoroscopic view of anatomy, radiofrequency ablation was performed during coronary sinus pacing at a cycle length of 600 ms.Bidirectional block was achieved with ablation in 29 (97%) of 30 patients. The transisthmus intervals before ablation and after complete transisthmus block were (73.82 +/- 13.01) ms and (140.47 +/- 20.48) ms, respectively, in the clockwise direction (P0.0001), and (77.63 +/- 8.36) ms and (138.17 +/- 15.55) ms, respectively, in the counterclockwise direction (P0.0001). A period of incomplete isthmus block was observed during 17 (58%) of the 29 ablation procedures. The clockwise transisthmus intervals during incomplete block [(107.65 +/- 21.33) ms] were (45.5 +/- 8.7)% longer than the baseline transisthmus intervals. An increase in the transisthmus interval byor = 50% in both directions after ablation predicted complete bidirectional block with 100.0% sensitivity and 83.3% specificity. The positive and negative predictive values were 90.6% and 100.0%, respectively. The diagnostic accuracy of aor = 50% prolongation in the transisthmus interval was 83.3%.The analysis of transisthmus interval is a valuable method for determining complete bidirectional isthmus block.

Objectives Using the spiral CT to scan coronary calcification, with qualitative and semi-quantitative method, to predict the presence and extent of coronary artery disease. Background Early diagnosis of coronary artery disease has been an important clinical issue. Coronary angiography was the gold standard for diagnosis of coronary artery disease, but to have invasive examination, only used in a small fraction of patients. Clinical diagnosis in most patients still need to rely on non-invasive examination. Women have a lower incidence of coronary artery disease, high load test false positive rate. Detection of coronary artery disease in female patients is very important. Coronary artery calcium deposition within the intima is a sign of atherosclerosis. CAC associated with the presence and extent of coronary atherosclerosis. Methods 108 symptomatic women (mean age 50±5; range 45–76 years) received coronary angiography and chest CT scan. CT image shows left main and at least proximal and middle part of anterior descending was considered acceptable CT scans, punctate calcification as mild, segmental calcification as moderate and diffuse as severe. Stenosis were measured in three vessels. Completely normal coronary artery was defined as no stenosis. Stenosis less than 50% was considered non-obstructive, while more than 50% stenosis as obstructive coronary artery disease. Results Of all the 108 patients, 41 confirmed by coronary angiography with normal coronary artery, 67 patients in contrast with the narrow, including 12 non-obstructive, 55 of obstructive stenosis. There were no difference in patient with or without obstructive stenosis. 41 patients with normal coronary angiography showed that 26 were not calcified, 15 with mild calcification. The sensitivity to predict obstructive CAD was 68.7%, specificity was 92.8%. Conclusion Symptomatic women patients without CAC on chest CT scan may have less possibility of obstructive CAD. Such patients may not need excessive coronary angiography.