Coronary Atherosclerotic Heart Disease Research Articles

RP105 protects against myocardial ischemia–reperfusion injury via suppressing TLR4 signaling pathways in rat model

Myocardial ischemia–reperfusion (I/R) injury severely impacts the postoperative survival rate of coronary atherosclerotic heart disease. Radioprotective 105kDa protein (RP105) is a regulator of Toll-like receptor 4 (TLR4), an inflammatory factor whose functions have been reported in myocardial I/R injury. To investigate the roles of RP105 in mediating myocardial I/R injury, we overexpressed RP105 by injecting its adenovirus vectors, and induced myocardial I/R injury rat model in this study. Myocardial structure injuries of rat hearts were examined by hematoxylin eosin staining, and myocardial infarct area was calculated after Evans blue and triphenyltetrazolium chloride dual staining. Expression changes of TLR4, myeloid differentiation factor 88 (MyD88), and nuclear factor κB (NF-κB) in myocardia were detected by quantitative real-time PCR and Western blot. Amount changes of tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) were detected by enzyme-linked immunosorbent assay. Results showed that RP105 attenuated myocardial injuries and effectively reduced myocardial infarct area after I/R (P<0.05). RP105 was also proved to significantly inhibit TLR4 and downstream inflammatory factors MyD88, NF-κB, TNF-α and IL-6 (P<0.05), whose expression levels were up-regulated by I/R induction. These results indicated that RP105 could protect against myocardial I/R injury via suppressing inflammatory responses mediated by TLR4 signaling pathways. This study revealed the anti-inflammatory roles of RP105 and its potential in preventing and treating myocardial I/R injury.

Clinical Features and Surgical Results of Right Atrial Myxoma.

We retrospectively analyzed 367 patients receiving surgical resection of cardiac myxomas in our center over six years, and analyzed the incidence and surgical results of 28 cases of right atrial myxomas. We also compared the age, gender, and attached sites between left atrial myxoma and right atrial myxoma. Between January 2007 and December 2012, 28 patients with right atrial myxomas underwent surgical resection. There were 16 males and 12 females. The mean age was 47.77 ± 13.20 years (range: 8.00-79.00 years). Associated cardiac lesions included moderate and severe tricuspid regurgitation in four, coronary atherosclerotic heart disease in five, and pulmonary embolism in one. Twenty-seven patients (96.43%) were followed from 26 to 94 months (mean 55.78 ± 21.10 months). There was no early death after operation. The incidence of right atrial myxomas among sporadic cardiac myxomas was 7.89%. One patient died of lung cancer 34 months after myxoma resection. Two patients underwent coronary artery stent implantation due to coronary atherosclerotic heart disease during the follow-up period. One patient underwent myxoma resection due to recurrence in the left atrium four years after the first operation. There was no significant difference in the age between left atrial myxoma and right atrial myxoma (p > 0.05). There was a significant difference in the gender between left atrial myxomas and right atrial myxomas (p < 0.05). The most common attached sites of left atrial myxomas and right atrial myxomas are the atrial septum. Surgical resection of the right atrial myxoma results in good clinical outcomes and a decreased incidence of recurrence.

Effects of Combination of Ezetimibe and Rosuvastatin on Coronary Artery Plaque in Patients with Coronary Heart Disease

In approximately 80% of cardiovascular disease-related deaths, patients suffer from coronary atherosclerotic heart disease. Ezetimibe is the first intestinal cholesterol absorption inhibitor. Its combination with statins for treating coronary atherosclerotic heart disease has attracted attention worldwide. The study group comprised 106 patients with coronary atherosclerotic heart disease and hyperlipidaemia. Each was randomly assigned to one of two groups: (1) Ezetimibe (10mg, once a night) plus rosuvastatin (10mg, once a night) (n=55) or (2) Rosuvastatin alone (10mg, once a night) (n=51). The primary endpoint was new or recurrent myocardial infarction, unstable angina pectoris, cardiac death, and stroke. Blood lipid, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and matrix metalloproteinase-9 (MMP-9) levels were measured before treatment and at one, six and 12 months after treatment. Coronary plaque size and compositional changes were determined using intravascular ultrasonography. The combination of ezetimibe plus rosuvastatin decreased total cholesterol, low-density lipoprotein cholesterol, hsCRP, IL-6, and MMP-9 levels at six and 12 months after treatment. Statistical significance was detected between two groups. At 12 months, the plaque burden, plaque cross-sectional area, and percentage of necrotic plaque composition were significantly lower in the combination group than in rosuvastatin alone group (P<0.05). And compared with rosuvastatin alone group, the primary endpoint decreased more effectively in combination group. The combination of ezetimibe and rosuvastatin apparently diminishes lipid levels and plaque burden and improves plaque stability, which may be associated with the potent inhibitory effects of ezetimibe and rosuvastatin on inflammatory cytokines.

Is the amount of coronary perivascular fat related to atherosclerosis?

Interesting and stimulating data about the effect of the perivascular adipose tissue size on atherogenesis are based mainly on CT findings. We studied this topic by directly analyzing perivascular adipose tissue in explanted hearts from patients undergoing transplantation. Ninety-six consecutive patients were included, including 58 with atherosclerotic coronary heart disease (CHD) and 38 with dilation cardiomyopathy (DCMP). The area of perivascular fat, area of the coronary artery wall, and ratio of CD68-positive macrophages within the perivascular fat and within the vascular wall were quantified by immunohistochemistry. There was no significant difference in the perivascular adipose tissue size between the two groups. Nevertheless, there was a significantly higher number of macrophages in the coronary arterial wall of CHD patients. In addition, we found a close relationship between the ratio of macrophages in the arterial wall and adjacent perivascular adipose tissue in the CHD group, but not in the DCMP group. According to our data interaction between macrophages in the arterial wall and macrophages in surrounding adipose tissue could be more important mechanism of atherogenesis than the size of this tissue itself.

The clinical value of serum sialic acid and lactadherin in the prognosis evaluation of atherosclerotic heart disease

Objective To discuss the effect and clinical value of serum sialic acid (SA)and lactadherin(MFG-E8)in the coronary atherosclerotic heart disease(CHD). Methods Selected 295 patients who visited to Wuhan University Renmin's Hospital cardiovascular medicine (from January to June, 2014), and then according to the results of coronary angiography divide the subjects into control group(n=78, the result of coronary angiography completely normal)and coronary heart disease group(n=217, the results of coronary angiography showed that one major coronary stenosis was more than 30%). Detected their serum level of lipid, SA, MFG-E8, hs-CRP index. At last, analyze the differences of SA and MFG-E8 between these groups, and the correlation with the severity of coronary stenosis (symbolize with Gensini score), use the binary logistic regression analysis to research the relationship among the serum level of SA, MFG-E8 and the risk of CHD. Results Compared with the control group, the patients with CHD have a higher level of serum SA and a lower level of MFG-E8 (U=4 402.5, 2 736.0 respectively, P<0.001); the AMI group has a higher level of serum SA than the StA and UA groups (U=1 329.0, 957.5 respectively, P<0.001); the AMI group has a lower level of serum MFG-E8 than the StA groups (U=1517.0, P<0.001). The spearman correlation analysis showed that the serum SA has a positively correlation with the level of TG, hs-CRP and Gensini score, and has a negatively correlated with the level of MFG-E8(r=0.214, 0.462, 0.378, -0.322 respectively, P<0.01); the MFG-E8 has a negatively correlated with the level of TG, hs-CRP and Gensini score (r=-0.18, -0.425, -0.564 respectively, P<0.01). Binary logistic regression analysis showed that there was a positive correlation between the serum SA and the risk of CHD (OD= 4.782, 5.319, 4.179 3.832, 3.648 respectively, P<0.001), and the was a negative correlation between the serum MFG-E8 and the risk of CHD (OD= 0.118, 0.112, 0.127, 0.135, 0.134 respectively, P<0.001). Conclusion With the serum SA rised and the MFG-E8 reduced, the risk of coronary heart disease was higher, combined detection these two indexes may be able to diagnose the CHD and assess the degree of stenosis and the risk of CHD.(Chin J Lab Med, 2015, 38: 746-750) Key words: Coronary disease; N-acetylneuraminic acid; Milk proteins; C-reactive protein; Risk factors

Atherosclerotic and Non-Atherosclerotic Coronary Heart Disease in Women.

Atherosclerotic Coronary heart disease (CHD) and non-atherosclerotic CHD in individuals less than 50 years of age is considered a "men's case". Undoubtedly, premenopausal women develop atherosclerotic/non-atherosclerotic CHD relatively rarely compared with men. This is attributed mostly to the cardioprotective role of estrogens (mainly estradiol). Nevertheless, there are predisposing conditions, which also make young women vulnerable to develop atherosclerotic/non-atherosclerotic CHD. Women who have classical cardiovascular (CV) risk factors, such as hypertension, diabetes mellitus, smoking, obesity, and dyslipidaemia, are more likely to develop cardiac events, even at a young age. Moreover, there are also other conditions that cause acute coronary syndromes, even in the absence of coronary atheromatic plaques such as myocardial bridge, coronary artery dissection, coronary artery spasm, coronary artery embolism and congenital anomalies of coronary arteries. Also, autoimmune diseases, some of which are more prevalent in women can cause atherosclerotic/ non-atherosclerotic CHD. In this narrative review we have summarized some of the causes that predispose young women to develop atherosclerotic/non-atherosclerotic CHD.

The Agenda for Familial Hypercholesterolemia

Familial hypercholesterolemia (FH) is an autosomal-dominant genetic disease present in all racial and ethnic groups and has long been recognized as a cause of premature atherosclerotic coronary heart disease.1–3 Heterozygous FH has the highest prevalence of genetic defects that cause significant premature mortality (≈1:200 to 1:500 or higher in founder populations). The genetic basis of the disorder, impaired functioning of the low-density lipoprotein (LDL) receptor, was first recognized by Goldstein and Brown4 in their Nobel Prize–winning work. Studies of LDL receptor function have identified additional mechanisms for the pathogenesis of FH (defects in apolipoprotein [apo] B impairing binding with the LDL receptor and gain-of-function mutations in proprotein convertase subtulisin/kexin type 9 [PCSK9] that enhance LDL receptor degradation). FH leads to elevated LDL concentrations, with levels in heterozygous FH generally in untreated adults >190 mg/dL LDL cholesterol (LDL-C) and in untreated children or adolescents >160 mg/dL LDL-C. Long-term exposure to elevated plasma concentrations of LDL-C begins in utero, leading in heterozygotes to premature ischemic heart disease in mid adulthood and in homozygotes to ischemic heart disease in childhood or early adulthood. In those who meet clinical definitions of FH based on LDL-C levels and family history, genetic testing identifies mutations in most children and a large percentage of adults.5,6 Complementing these cell biology discoveries has been drug discovery that has linked enhancement of LDL receptor function to LDL-C lowering and successful prevention of ischemic heart disease, first with statins and now with newer drugs that affect LDL receptor function in other ways, including those that impair PCSK9 regulation of LDL receptor recycling.7 The natural history of FH, the natural history of genetic disorders that lead to lifelong low LDL-C, and the dramatic improvement in life expectancy created by effective cholesterol lowering provide the …

GW26-e3972 Non-alcoholic fatty liver disease affects the relationship between epicardium and coronary atherosclerotic heart disease

GW26-e3972 Non-alcoholic fatty liver disease affects the relationship between epicardium and coronary atherosclerotic heart disease

Knockdown of connexin 43 attenuates balloon injury-induced vascular restenosis through the inhibition of the proliferation and migration of vascular smooth muscle cells

Coronary artery disease (CAD) or atherosclerotic heart disease is one of the most common types of cardiovascular disease. Although percutaneous coronary intervention [PCI or percutaneous transluminal coronary angioplasty (PTCA)] is a mature, well-established technique used to treat atherosclerotic heart disease, its long‑term therapeutic effects are compromised by a high incidence of vascular restenosis (RS) following angioplasty. In our previous study, we found that the principal gap junction protein, connexin 43 (Cx43), in vascular smooth muscle cells (VSMCs) was involved in the development of vascular RS following angioplasty-induced balloon injury. However, the exact role action of Cx43 in vascular RS remains unclear. In the present study, we aimed to further examine whether the knockdown of Cx43 attenuates the development of vascular RS through the inhibition of the proliferation and migration of VSMCs. We found that the use of a lentiviral vector expressing shRNA targeting Cx43 (Cx43‑RNAi-LV) efficiently silenced the mRNA and protein expression of Cx43 in cultured VSMCs. In addition, MTT and Transwell assays were used to examined the proliferation and migration of the VSMCs, respectively. The results revealed that the knockdown of Cx43 by Cx43-RNAi-LV at a multiplicity of infection (MOI) of 100 significantly inhibited the proliferation and migration of the VSMCs in vitro. Notably, the knockdown of Cx43 also effectively attenuated the development of vascular RS and intimal hyperplasia following balloon injury in vivo. Taken together, our data suggest that Cx43 is involved in the development of vascular RS and intimal hyperplasia through the regulation of the proliferation and migration of VSMCs. Thus, the present study provides new insight into the pathogenesis of vascular RS, and suggests that further comfirms that Cx43 may well be a novel potential pharmacological target for preventing vascular RS following PCI.

The effect of Diltiazem on the major adverse cardiac events after percutaneous coronary intervention

Objective To detect the impact of Diltiazem on the major adverse cardiac events (MACE) in six months after percutaneous coronary intervention (PCI). Methods A total of 192 patients after PCI with coronary atherosclerotic heart disease were enrolled in this study. The patients were randomly divided into Diltiazem therapy group (101 patients) and non-Diltiazem therapy group (91 patients). The high-sensitivity C-reactive protein (hs-CRP) was assessed before and 24 h after PCI, and the incidence of Major adverse cardiovascular events(MACEs) were assessed at the sixth month after PCI. Results Compared with before PCI, hs-CRP level increased significantly in both group after PCI (P<0.01), but hs-CRP level was lower in Diltiazem therapy group than in non-Diltiazem therapy group (P<0.05 ). Compared with non-Diltiazem therapy group, there was lower incidence of MACEs during six months follow-up in Diltiazem therapy group. Conclusions Diltiazem can decrease the incidence of MACEs during six months after PCI. Key words: Coronary diseose; Angioplasty, transluminal, percutaneous coronary; Calcium channel blockers; C-reactive protein

Influence of metabolic syndrome factors and insulin resistance on the efficacy of ezetimibe/simvastatin and atorvastatin in patients with metabolic syndrome and atherosclerotic coronary heart disease risk.

BackgroundMetabolic syndrome (MetS) and insulin resistance (IR) are increasing in prevalence, are associated with higher risk for coronary heart disease (CHD), and may potentially influence the responses to lipid-altering drug therapy. This study evaluated the effects of MetS factors (abdominal obesity, depleted high-density lipoprotein cholesterol [HDL-C], and elevated triglycerides, blood pressure, and fasting glucose) and IR on ezetimibe/simvastatin and atorvastatin treatment efficacy in patients with MetS.MethodsThis post-hoc analysis of a multicenter, 6-week, double-blind, randomized, parallel group study of 1128 subjects with hypercholesterolemia, MetS, and moderately high/high CHD risk evaluated the effects of baseline MetS factors/IR on percent change from baseline in lipids, apolipoproteins, and high-sensitivity C-reactive protein (hs-CRP), after treatment with the usual starting doses of ezetimibe/simvastatin (10/20 mg) versus atorvastatin (10 mg, 20 mg) and next higher doses (10/40 mg versus 40 mg).ResultsEzetimibe/simvastatin and atorvastatin efficacy was generally consistent across MetS factor/IR subgroups. Ezetimibe/simvastatin produced greater incremental percent reductions in LDL-C, non-HDL-C, apolipoprotein B, total cholesterol, and lipoprotein ratios for all subgroups, and larger percent increases in HDL-C and apolipoprotein AI for all but non-obese and HDL-C ≥40 mg/dL subgroups than atorvastatin at the doses compared. Triglycerides, very-LDL-C, and hs-CRP results were more variable but similar between treatment groups.ConclusionThe magnitude of lipid-altering effects produced by each treatment regimen was generally similar across all MetS and IR subgroups. Ezetimibe/simvastatin produced greater percent reductions in most lipid fractions than atorvastatin at the dose comparisons studied, and all treatments were generally well tolerated. (Registered at clinicaltrials.gov: NCT00409773)

Design and methods of the Gentle Cardiac Rehabilitation Study — A behavioral study of tai chi exercise for patients not attending cardiac rehabilitation

IntroductionCardiac rehabilitation (CR) programs reduce overall and cardiovascular mortality in patients with a history of acute coronary events or revascularization procedures, but only 30% of patients enroll in CR and attrition rates reach up to 60%. Tai chi, a mind-body practice based on light/moderate aerobic exercise accompanied by meditative components could be a possible exercise option for patients who do not attend CR. Methods/designSixty patients will be randomized to a “LITE” condition (one tai chi session twice weekly for 12weeks) or to a “PLUS” condition (one tai chi session 3 times weekly for 12weeks, followed by maintenance classes 1–2 times weekly for an additional 12weeks). Measurements will be conducted at baseline, 3-, 6-, and 9months after enrollment. The primary outcome is to determine the feasibility, acceptability and safety of each dose. Secondary outcomes include estimates of effect size of each dose on accelerometry-assessed physical activity; the proportion of patients meeting current recommendations for physical activity; and measures of fitness, quality of life, body weight, and sleep. In addition, we will collect exploratory information on possible mediators (exercise self-efficacy, perceived social support, resilience, mindfulness, and depression). ConclusionsFindings from this pilot study will provide preliminary indications about the usefulness of tai chi as an exercise option for patients not attending traditional CR programs. Results will also shed light on the possible mechanisms by which tai chi practice may improve overall physical activity among patients with atherosclerotic coronary heart disease.

Risk Factors Associated with Recurrent Strokes in Young and Elderly Patients: A Hospital-based Study

Recurrent stroke is often devastating, and can cause severe disability or death. Risk factors associated with recurrent strokes unrelated to atrial fibrillation have been well identified; however, it remains to be further elucidated whether the risk factors for recurrent stroke are the same in young as in older patients. Data from 1017 stroke patients unrelated to atrial fibrillation were retrospectively reviewed. Risk factors analyzed included sex, smoking history, previous history of ischemic stroke or transient ischemic attack, hypertension, diabetes mellitus, coronary atherosclerotic heart disease, and previous myocardial infarction. All patients were followed up via telephone 1 year after their initial strokes. Logistic regression was used to assess the associations between the various factors and risk of recurrent stroke events. Predictive independent risk factors of recurrent stroke in older men included previous history of myocardial infarction [odds ratio (OR), 6.761; 95% confidence interval (CI), 1.030–44.371], ischemic stroke or transient ischemic attack (OR, 2.496; 95% CI, 1.567–3.976), diabetes mellitus (OR, 1.986; 95% CI, 1.223–3.227), and coronary atherosclerotic disease (OR, 1.733; 95% CI, 1.010–2.974). In young men, hypertension (OR, 1.709; 95% CI, 1.104–2.645), coronary atherosclerotic heart disease (OR, 1.812; 95% CI, 1.129–2.911), and previous history of ischemic stroke or transient ischemic attack (OR, 2.317; 95% CI, 1.580–3.397) were independent risk factors of recurrent strokes. The predictive independent risk factors of recurrent stroke differ between young and older stroke patients. Our findings may help guide the prevention of recurrent strokes.

Abstract 190: Continuous Vascular Remodeling Related To Development Of Arteriosclerosis Or Atherosclerosis In Kawasaki Disease ~ Immunohistochemical Study using an Animal Model ~

Background: Atherosclerotic coronary heart disease has recently emerged as a clinical issue among young individuals with a history of Kawasaki disease (KD), which is a systemic vasculitis unique to children. However, whether or not and how KD promotes atherosclerosis remains unclear. We hypothesized that, analogous to the pathogenesis of arteriosclerosis or atherosclerosis, endothelial injury and the resultant intimal thickening are induced in coronary arteries after attenuation of vasculitis. Methods: We used a rabbit model of KD developed by Onouchi et al. and performed histopathological analysis of the coronary arteries at acute (1, 3, 5, and 7 days) and chronic (3 months) phases of the disease. Results: In these rabbit models, a pan-arteritis with significant intimal cellular hypertrophy was histologically detected in the acute phase, and arterial intimal thickening was observed during the chronic phase. Immunohistochemical analysis of the coronary arteries revealed that the thickened intimal lesions observed during the chronic phase comprised abundant α-smooth muscle actin (α-SMA)-positive cells, most of which concomitantly expressed vascular cell adhesion molecule-1 and nuclear factor-κB. Although macrophages positive for RAM11 were barely detected, macrophage colony stimulating factor was strongly expressed in migrating smooth muscle cells in the intimal layer. In addition, the accumulation of proteoglycan as extracellular matrix was distinctly visible in the thickened intima, indicating progressive accumulation of lipids and proliferation of smooth muscle cells within the lesion. Conclusions: These findings suggest that, in KD-associated vasculitis, the migration of α-SMA-positive cells into the thickened intima might induce continuous vascular inflammation and remodeling, which might progress to coronary arteriosclerosis or atherosclerosis.

Ophiopogon japonicus strains from different cultivation regions exhibit markedly different properties on cytotoxicity, pregnane X receptor activation and cytochrome P450 3A4 induction.

Maidong, known as Ophiopogon japonicus, is one of the two basic ingredients of Shenmai injection, which is a widely used herbal preparation in traditional Chinese medicine (TCM) for the treatment of atherosclerotic coronary heart disease and viral myocarditis. Previously, the ethanol extract of Maidong activated the pregnane X receptor (PXR) signaling pathway and induced the cytochrome P450 3A4 (CYP3A4) reporter gene and raised the concern of herb-drug interactions (HDIs) when Maidong was used in combination with prescribed drugs metabolized by CYP3A4. Therefore, the present study further investigated and compared the differences of the ethanol and aqueous extracts (ee- and ae-, respectively) of two Maidong strains, known as Zhe Maidong (ZM) and Chuan Maidong (CM). Cytotoxicity, PXR activation and CYP3A4 induction by the 3-(4,5)-dimethylthiahiazo-(-z-y1)-3,5-diphenytetrazoliumromide assay, reporter gene assay and reverse transcription-quantitative polymerase chain reaction analysis were examined. The observations showed that ee-ZM demonstrated a significantly higher cytotoxicity, a relatively weaker PXR activation capability and a markedly stronger CYP3A4-inducing capacity than ee-CM. Compared to ae-CM, ae-ZM exhibited only a slight or no difference on cytotoxicity and CYP3A4 induction, while a significant lower level of PXR activation was apparent. Collectively, Maidong from different producing areas possess different properties upon cytotoxicity and the drug-metabolizing enzyme inducing effect, and attention should be paid to the selection of Maidong strains from different planting regions into TCM preparations for reducing potential adverse reactions and HDIs.

EXPERIMENTAL IMMUNOHISTOCHEMICAL STUDY ON PERSISTENT VASCULAR REMODELING RELATED TO DEVELOPMENT OF ARTERIOSCLEROSIS OR ATHEROSCLEROSIS IN CHRONIC KAWASAKI DISEASE PATIENTS

Atherosclerotic coronary heart disease has recently emerged as a clinical issue among young individuals with a history of Kawasaki disease (KD), which is a systemic vasculitis unique to children. However, whether or not and how KD promotes atherosclerosis remains unclear. We hypothesized that,

Intravascular ultrasound study of coronary artery remodeling and plaque composition in patients with coronary atherosclerotic heart disease

Objective To demonstrate the relationship between plaque composition and coronary artery remodeling in the same patient′s blood vessel. Methods A total of 48 coronary artery plaque were included in this study. Qualitative assessment and quantitative measurements of the lesion were performed in target lesions. The lesions were classified into soft plaque, fibrous plaque, calcified plaque and mixed plaque according to different degree of reflection of ultrasound signal. The remodeling index (RI) was defined as the ratio of external elastic membrane cross sectional area of lesion segment to the mean reference external elastic membrane cross sectional area. Results In comparison to hard plaque group, RI of soft plaque group was significantly larger in the same patient (1.08±0.15 vs 1.00±0.13, P=0.000). Soft plaque group presented with more positive remodeling than hard plaque group, but with P value more than 0.05 (83.3% vs 58.3%, P=0.057). The plaque area, lumen area and plaque burden were not different between two group (P>0.05). Conclusions The blood vessel was compensatively dilated in soft plaque segments and RI was significantly larger than in hard plaque segments. Coronary atherosclerotic vessel presented positive remodeling in the acute stage of inflammation. Key words: Endosonography; Coronary artery heart disease; Remodeling; Plaque; Atherosclerotic

The roles of a novel inflammatory neopterin in subjects with coronary atherosclerotic heart disease

Coronary atherosclerotic heart disease (CHD) is currently regarded as a chronic inflammatory disease. The inflammatory cytokine neopterin (NP) is a new predictor of the stable type of atherosclerotic plaque, and this study focused on the relationship between neopterin, Gensini score and high-sensitivity C-reactive protein (Hs-CRP) to explore the important role of neopterin in patients with CHD. This study enrolled 176 patients into the control group and 266 patients into the experimental group. The Gensini score was used to assess the severity of the coronary lesions, enzyme-linked immunosorbent assays (ELISAs) were used to measure the serum NP level, and other indicators were assessed using a fully automatic biochemical analyzer. The data were analyzed using SPSS19.0 statistical software. The serum NP level was higher in the experimental group than in the control group (132.23±6.40ng/mL vs. 40.95±2.67ng/mL, P<0.001). Compared with the stable angina (SA) group, the serum NP level was significantly increased in the unstable angina (UA) group (135.99±12.45ng/mL) and the acute myocardial infarction (AMI) group (173.66±13.59ng/mL) (P<0.05). In addition, the serum NP level was positively correlated with the Gensini score (r=0.687, P<0.001) as well as with the level of Hs-CRP (r=0.190, P<0.001). The serum level of NP was significantly higher in patients with CHD and was positively correlated with the severity of CHD. Thus, NP may become a new indicator for the assessment of the inflammatory response in coronary atherosclerosis.

The screening value of baPWV and hs-crp to ASCVD in middle and elderly community population in Shanghai

Atherosclerotic cardiovascular disease (ASCVD) is a major cause of mortality globally. In November 2013, American College of Cardiology and American Heart Association published a new guideline of how to reduce the ASCVD risk [ 1 Smith Jr., S.C. Grundy S.M. 2013 ACC/AHA guideline recommends fixed-dose strategies instead of targeted goals to lower blood cholesterol. J. Am. Coll. Cardiol. Aug. 12 2014; 64: 601-612 Crossref PubMed Scopus (52) Google Scholar , 2 Lee K. 10-year risk for atherosclerotic cardiovascular disease and coronary heart disease among Korean adults: findings from the Korean National Health and Nutrition Examination Survey 2009–2010. Int. J. Cardiol. Sep. 20 2014; 176: 418-422 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar , 3 Kavousi M. Leening M.J. Nanchen D. et al. Comparison of application of the ACC/AHA guidelines, Adult Treatment Panel III guidelines, and European Society of Cardiology guidelines for cardiovascular disease prevention in a European cohort. JAMA. Apr. 9 2014; 311: 1416-1423 Crossref PubMed Scopus (250) Google Scholar ]. The new guideline reinforced statin therapy for control of cholesterol level to reduce the ASCVD events [ 4 Strandberg T.E. Kolehmainen L. Vuorio A. Evaluation and treatment of older patients with hypercholesterolemia: a clinical review. JAMA. Sep. 17 2014; 312: 1136-1144 Crossref PubMed Scopus (100) Google Scholar , 5 Stone N.J. Robinson J.G. Lichtenstein A.H. et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. Jun. 24 2014; 129: S1-S45 Crossref PubMed Scopus (3018) Google Scholar ]. However, there was still not a simple and stable screening predictor to ASCVD in community population.

GW25-e0508 Effects of impaired glucose metabolism on heart rate variability in patients with coronary atherosclerotic heart disease

GW25-e0508 Effects of impaired glucose metabolism on heart rate variability in patients with coronary atherosclerotic heart disease