Angiology最新文献

We investigated the prognostic implications of the systemic immune-inflammatory index (SII), atherogenic index of plasma (AIP), C-reactive protein/albumin ratio (CAR), neutrophil-lymphocyte ratio (NLR), prognostic nutritional index (PNI), and triglyceride/glucose index (TGI) in the MORtality predictors in the CORonary Care Units in TURKey (MORCOR-TURK) population. This is the largest registry of coronary care unit (CCU) patients in Turkey (3157 patients admitted to CCU in 50 different centers). The study population was divided into two according to in-hospital survival status; 137 patients (4.3%) died in-hospital follow-up. A significant correlation was found between death and SII, CAR, NLR, and PNI but not for AIP and TGI in logistic regression. In Model 1 (combining parameters proven to be risk predictors), the -2 log-likelihood ratio was 888.439, Nagelkerke R² was 0.235, and AUC (area under curve) was 0.814 (95% CI: 0.771-0.858). All other models were constructed by adding each inflammatory marker separately to Model 1. Only Model 3 (CAR + Model 1) had a significantly greater AUC than Model 1 (DeLong P = .01). Our study showed that CAR, but not other inflammatory index, is a significant predictor of in-hospital mortality in CCU patients when added to proven risk predictors.

Percutaneous balloon pericardiotomy (PBP) has emerged as a less invasive alternative to surgical interventions for recurrent severe pericardial effusion (PE), particularly in patients with malignancies. This study evaluates the safety and efficacy of PBP in patients with recurrent severe PE. A total of 42 patients with recurrent severe PE underwent PBP between March 2008 and July 2024. PBP was performed under conscious sedation with fluoroscopic guidance using a 20-mm by 60-mm balloon. Data were collected on patient demographics, echocardiographic findings, procedural details, and follow-up outcomes. The study population had a mean age of 58.4 ± 11.2 years, with 54.8% being female. Most patients (76.2%) had malignant PEs. The procedure was technically successful in all cases, with no immediate complications. The median hospital stay was 4 days. Post-procedural transthoracic echocardiography showed no residual effusion in 40.5% of patients and minimal effusion in 50%. Over a median follow-up of 353 days, 54.8% of patients died due to the progression of underlying malignancies, and four patients experienced recurrent effusions requiring additional intervention. PBP is a safe and effective treatment for recurrent severe PE, particularly in patients with malignancies. The procedure's high success rate and favorable safety profile suggest it might be considered a first-line treatment option in appropriate clinical settings.

Infantile hemangioma (IH), a benign microvascular tumor, is marked by early and extensive proliferation of immature hemangioma endothelial cells (Hem-ECs) that naturally regress through differentiation into fibroblasts or adipocytes. However, a challenge persists, as the unique biological behavior of IH remains elusive, despite its general sensitivity to propranolol treatment. Recent evidence suggests that abnormal volume proliferation in IH is primarily attributed to the accumulation of hemangioma pericytes (Hem-Pericytes), in addition to Hem-ECs. Centromere protein F (CENPF) is involved in regulating mitotic processes and has been associated with malignant tumor cell proliferation. It is a key player in maintaining genomic stability during cell division. Our findings revealed specific expression of CENPF in Hem-Pericytes, with a proliferation index (PI) approximately half that of Ki67 (3.28 vs 6.97%) during the proliferative phase of IH. This index decreased rapidly in the involuting phase (P < .05), suggesting that the contribution of pericytes to IH development was comparable to that of Hem-ECs. Tumor expansion and shrinkage may be due to the proliferation, reduction, and differentiation of Hem-Pericytes. In conclusion, we speculate CENPF as a novel marker for clinical pathological diagnosis and a potential therapeutic target, fostering advancements in drug development.

To explore the effect of long non-coding RNA cancer susceptibility 19 (lncRNA CASC19) on the activity, apoptosis, and oxidative stress response of cardiomyocytes, so as to assess the clinical relevance and molecular mechanism of CASC19 in myocardial infarction (MI). CASC19 level was determined by using real-time quantitative polymerase chain reaction (RT-qPCR). MI model was constructed using hypoxia induction, and rat cardiomyocytes H9c2 were divided into control group, MI group, MI small interference negative control (MI-si-NC) group, MI-si-CASC19 group, MI-si-CASC19+microRNA-NC (miR-NC) group, and MI-si-CASC19+miR-218-5p inhibitor group. Tetramethylazolium salt colorimetric method and flow cytometry were used to evaluate cell activity and apoptotic capacity. Cellular oxidative stress was evaluated using malondialdehyde and superoxide dismutase kits. The relationship between CASC19 and miR-218-5p was confirmed by using dual-luciferase activity assay. CASC19 levels were enhanced in MI patients and hypoxia-induced cardiomyocytes. Downregulating CASC19 promoted the proliferation, while suppressed apoptosis and oxidative stress in the MI cell model. Moreover, low expression of miR-218-5p reversed the promotion of proliferation and inhibition of apoptosis and oxidative stress in MI cell models by silencing CASC19. Briefly, CASC19 may serve as a diagnostic marker for MI by sponging miR-218-5p to inhibit apoptosis and oxidative stress in cardiomyocytes and promote cell survival.

This study evaluated the association of lymphocyte-based composite inflammatory indices with lower extremity arteriosclerosis obliterans (LEASO). PubMed, Embase, Cochrane Library, and Web of Science were searched up to March 12, 2024. The endpoints included mortality, amputation, restenosis, major adverse limb events, and amputation-free survival (AFS). In total, 33 studies were included (n = 12 386). For categorical variables, the results showed that high neutrophil-to-lymphocyte ratio (NLR) was closely associated with mortality, restenosis, amputation, and AFS (OR: 1.31; 95% CI: 1.17-1.47, 1.46; 95% CI: 1.15-1.84, 1.83; 95% CI: 1.48-2.27 and 2.29; 95% CI: 1.75-3.00, respectively; all P < .00001). High platelet-to-lymphocyte ratio (PLR) was not significantly associated with mortality, restenosis, and amputation. High systemic immune-inflammation index (SII) was not significantly correlated with restenosis. For continuous variables, NLR and PLR were correlated with amputation, while the relationship between lymphocyte to monocyte ratio (LMR) and amputation was relatively weak. Subgroup analysis revealed that preoperative NLR testing was more valuable in predicting mortality and restenosis than postoperative testing. High NLR is significantly associated with amputation, restenosis, and AFS of LEASO patients. Furthermore, preoperative NLR is more accurate in predicting LEASO prognosis. PLR, LMR, and SII are not insignificant correlated with LEASO prognosis.

The association between abnormal ankle-brachial index (ABI) and adverse prognosis in patients with acute coronary syndrome (ACS) remains insufficiently characterized. The present meta-analysis aims to assess this association. A systematic search of Web of Science, PubMed, and Embase databases was conducted to identify relevant studies. An abnormal ABI was usually defined as ≤0.9 or >1.4. Pooled adjusted hazard ratios (HR) with 95% confidence intervals (CI) were used to assess the prognostic value of the abnormal ABI. Nine studies comprising 5647 patients were included. Abnormal ABI was significantly associated with an increased risk of major adverse cardiovascular events (MACEs; HR 2.39; 95% CI 1.76-3.23), cardiovascular mortality (HR 2.19; 95% CI 1.27-3.78), and all-cause mortality (HR 2.00; 95% CI 1.57-2.55). An abnormal ABI appears to be a significant predictor for increased mortality and MACEs in ACS patients. While the evidence strongly associates a low ABI with this risk, the current literature lacks explicit comparative data on the prognostic value of a high ABI. A low ABI may help refine risk stratification in ACS patients but requires validation in prospective studies.

The present study retrospectively assessed clinical outcomes of proximal optimization technique (POT)-kissing-POT (PKP) and POT-side-POT (PSP) in ST-segment elevation myocardial infarction (STEMI) patients with culprit coronary bifurcation lesion (CBL) following a provisional stenting (PS). This large-scale multicenter (n = 10) study included STEMI patients with culprit CBLs who underwent PKP or PSP following PS. The primary endpoint was defined as the major adverse cardiac events (MACE; cardiac death, target vessel myocardial infarction [TVMI], or clinically driven target lesion revascularization [TLR]). Consecutive patients (n = 596; male: 491 [82.3%], mean age: 58.1 ± 11.7 years) were included. The study cohort was divided into 2 groups: PKP (n = 386) and PSP (n = 210). In the overall population, mid-term MACE (hazard ratio [HR]: 0.921, P = .461) did not differ in individuals with CBL-related STEMI treated with either PKP or PSP. The frequency of main vessel-TLR (0% vs 30%, P = .001) and main vessel-TVMI (0% vs 20%, P = .014) were significantly lower in the PKP group in the left main bifurcation localization. Diabetes mellitus (HR: 2.628, P < .001), high SYNTAX score (HR: 1.081, P < .001), and bifurcation localization (HR: 2.109, P = .014) were found to be independent predictors of MACE. In the overall population, risk-adjusted MACE rates for culprit CBLs were comparable between both techniques.