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Bai X, Qi Z, Cai C, Song H, Song G, Zhao X. Improved therapeutic effects on vascular intimal hyperplasia by mesenchymal stem cells expressing MIR155HG that function as a ceRNA for microRNA-205. J Cell Mol Med 2024; 28:e18351. [PMID: 38693854 PMCID: PMC11063722 DOI: 10.1111/jcmm.18351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 03/30/2024] [Accepted: 04/11/2024] [Indexed: 05/03/2024] Open
Abstract
Coronary artery bypass grafting (CABG) is an effective treatment for coronary heart disease, with vascular transplantation as the key procedure. Intimal hyperplasia (IH) gradually leads to vascular stenosis, seriously affecting the curative effect of CABG. Mesenchymal stem cells (MSCs) were used to alleviate IH, but the effect was not satisfactory. This work aimed to investigate whether lncRNA MIR155HG could improve the efficacy of MSCs in the treatment of IH and to elucidate the role of the competing endogenous RNA (ceRNA). The effect of MIR155HG on MSCs function was investigated, while the proteins involved were assessed. IH was detected by HE and Van Gieson staining. miRNAs as the target of lncRNA were selected by bioinformatics analysis. qRT-PCR and dual-luciferase reporter assay were performed to verify the binding sites of lncRNA-miRNA. The apoptosis, Elisa and tube formation assay revealed the effect of ceRNA on the endothelial protection of MIR155HG-MSCs. We observed that MIR155HG improved the effect of MSCs on IH by promoting viability and migration. MIR155HG worked as a sponge for miR-205. MIR155HG/miR-205 significantly improved the function of MSCs, avoiding apoptosis and inducing angiogenesis. The improved therapeutic effects of MSCs on IH might be due to the ceRNA role of MIR155HG/miR-205.
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Affiliation(s)
- Xiao Bai
- Department of Cardiovascular SurgeryQilu Hospital of Shandong UniversityJinanChina
- Thoracoscopy Institute of Cardiac SurgeryShandong UniversityJinanChina
| | - Zaiwen Qi
- The Fifth People's Hospital of JinanJinanChina
| | - Chuanliang Cai
- Department of Cardiovascular SurgeryQilu Hospital of Shandong UniversityJinanChina
| | - Hao Song
- Department of Cardiovascular SurgeryQilu Hospital of Shandong UniversityJinanChina
| | - Guangmin Song
- Department of Cardiovascular SurgeryQilu Hospital of Shandong UniversityJinanChina
| | - Xin Zhao
- Department of Cardiovascular SurgeryQilu Hospital of Shandong UniversityJinanChina
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2
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Oguz M, Torun A. Prognostic Value of Systemic Immune-Inflammation Index in Predicting Premature Saphenous Vein Graft Disease in Patients With Coronary Artery Bypass Grafting. Cureus 2023; 15:e42833. [PMID: 37664391 PMCID: PMC10472081 DOI: 10.7759/cureus.42833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Systemic inflammation is a risk factor for premature coronary artery disease (CAD), and systemic immune-inflammation index (SII), a new marker of systemic inflammation, is linked to the severity and prognosis of CAD. However, the prognosis of the SII in bypass patients' venous saphenous grafts has not been adequately evaluated. This study aimed to evaluate the prognostic value of SII in predicting premature saphenous vein graft disease (SVGD) in patients who underwent bypass surgery with venous saphenous grafts. METHODS We retrospectively included 422 patients who had saphenous vein grafts (SVG) at least one year after bypass surgery. Of these, 222 patients had SVGD, and 200 had patent SVG. RESULTS SII was higher in the SVGD group than in the control group (631.55 ± 397.84, 421.71 ± 351.07, P=0.001). A receiver operating characteristic (ROC) analysis was performed to identify the optimal cutoff point with the highest sensitivity and specificity. The optimal cutoff point for SII was defined as 430. Using a cutoff level of >430, SII predicted SVGD with a sensitivity of 73% and specificity of 56%. CONCLUSION Our study demonstrated that SII was substantially higher in patients with SVGD than in those with patent SVG. SII predicted SVGD in bypass surgery patients. SII may be a helpful parameter for identifying patients at high risk of SVGD and guiding preventive treatments.
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Affiliation(s)
- Mustafa Oguz
- Department of Cardiology, Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul, TUR
| | - Akin Torun
- Department of Cardiology, Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul, TUR
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3
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Li XW, Cui Z, Xiao JY, Gao MD, Zhang M, Zhang WJ, Tian FS, Song Y, Liu YW, Yao ZH, Ma J, Liu Y, Gao J. A five-parameter score for predicting saphenous vein graft degenerative and/or occlusive disease in recurring ischemic symptoms after one year post coronary artery bypass grafting. Perfusion 2022; 38:843-852. [PMID: 35583035 DOI: 10.1177/02676591221090588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The recurrence rate of ischemic symptoms after coronary artery bypass grafting (CABG) is increasing in recent years. How to prevent and treat saphenous vein graft disease (SVGD [symptomatic ⩾50% stenosis in at least one Saphenous vein graft]) has been a clinical challenge to date. Different pathogenesis may exist in SVGD of different periods. There are currently few available scores for estimating the risk of SVGD after one year post CABG. OBJECTIVE We sought to develop and validate a simple predictive clinical risk score for SVGD with recurring ischemia after one year post CABG. METHODS AND RESULTS This was a cross-sectional study and the results were validated using bootstrap resampling on a separate cohort. A nomogram and risk scoring system were developed based on retrospective data from a training cohort of 606 consecutive patients with recurring ischemia >1 year after CABG. Logistic regression model was used to find the predictive factors and to build a nomogram. To assess the generalization, models were validated using bootstrap resampling and an external cross-sectional study of 187 consecutive patients in four other hospitals. In multivariable analysis of the primary cohort, native lesion vessel number, SVG age, recurring ischemia type, very low-density lipoprotein level, and left ventricular end-diastolic diameter were independent predictors. A summary risk score was derived from nomogram, with a cut-off value of 15. In internal and external validation, the C-index was 0.86 and 0.82, indicating good discrimination. The calibration curve for probability of SVGD showed optimal agreement between actual observations and risk score prediction. CONCLUSION A simple-to-use risk scoring system based on five easily variables was developed and validated to predict the risk of SVGD among patients who recurring ischemia after one year post CABG. This score may be useful for providing patients with individualized estimates of SVGD risk.
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Affiliation(s)
- Xiao-Wei Li
- Tianjin Medical University, Tianjin, China.,Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China.,Cardiovascular Institute, 499773Tianjin Chest Hospital, Tianjin, China
| | - Zhuang Cui
- Tianjin Medical University, Tianjin, China
| | - Jian-Yong Xiao
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China
| | - Ming-Dong Gao
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China
| | - Mei Zhang
- Tianjin Logistics University of Chinese People's Armed Police Forces, Tianjin, China
| | - Wen-Juan Zhang
- Tianjin Medical University General Hospital, Tianjin, China
| | | | - Yu Song
- TEDA International Cardiovascular Hospital, Tianjin, China
| | - Ying-Wu Liu
- Tian Jin Third Center Hospital, Tianjin, China
| | | | - Jun Ma
- Tianjin Medical University, Tianjin, China
| | - Yin Liu
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China
| | - Jing Gao
- Tianjin Medical University, Tianjin, China.,Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China.,Cardiovascular Institute, 499773Tianjin Chest Hospital, Tianjin, China
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4
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Yavuz S, Engin M, Yazgan E, Demir OF, Turk T. Letter: Potential Predictors of Saphenous Vein Graft Disease After Coronary Artery Bypass Operations. Angiology 2022; 73:689-690. [DOI: 10.1177/00033197211065559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Senol Yavuz
- Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Mesut Engin
- Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Elif Yazgan
- Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Omer Furkan Demir
- Department of Cardiology, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Tamer Turk
- Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
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Bonaterra GA, Struck N, Zuegel S, Schwarz A, Mey L, Schwarzbach H, Strelau J, Kinscherf R. Characterization of atherosclerotic plaques in blood vessels with low oxygenated blood and blood pressure (Pulmonary trunk): role of growth differentiation factor-15 (GDF-15). BMC Cardiovasc Disord 2021; 21:601. [PMID: 34920697 PMCID: PMC8684150 DOI: 10.1186/s12872-021-02420-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Growth differentiation factor (GDF)-15 is linked to inflammation, cancer, and atherosclerosis. GDF-15 is expressed in most tissues but is extremely induced under pathological conditions. Elevated serum levels are suggested as a risk factor and a marker for cardiovascular diseases. However, the cellular sources and the effects of GDF-15 on the cardiovascular system have not been completely elucidated including progression, and morphology of atherosclerotic plaques. Thus, this work aimed to characterize the influence of GDF-15 deficiency on the morphology of atherosclerotic plaques in blood vessels with low-oxygen blood and low blood pressure as the pulmonary trunk (PT), in hypercholesterolemic ApoE-/- mice. METHODS GDF-15-/- ApoE-/- mice were generated by crossbreeding of ApoE-/-- and GDF-15-/- mice. After feeding a cholesterol-enriched diet (CED) for 20 weeks, samples of the brachiocephalic trunk (BT) and PT were dissected and lumen stenosis (LS) was measured. Furthermore, changes in the cellularity of the PT, amounts of apoptosis-, autophagy-, inflammation- and proliferation-relevant proteins were immunohisto-morphometrically analyzed. Additionally, we examined an atherosclerotic plaque in a human post mortem sample of the pulmonary artery. RESULTS After CED the body weight of GDF-15-/-ApoE-/- was 22.9% higher than ApoE-/-. Double knockout mice showed also an 35.3% increase of plasma triglyceride levels, whereas plasma cholesterol was similar in both genotypes. LS in the BT and PT of GDF-15-/-ApoE-/- mice was significantly reduced by 19.0% and by 6.7% compared to ApoE-/-. Comparing LS in PT and BT of the same genotype revealed a significant 38.8% (ApoE-/-) or 26.4% (GDF-15-/-ApoE-/-) lower LS in the PT. Immunohistomorphometry of atherosclerotic lesions in PT of GDF-15-/-ApoE-/- revealed significantly increased levels (39.8% and 7.3%) of CD68 + macrophages (MΦ) and α-actin + smooth muscle cells than in ApoE-/-. The density of TUNEL + , apoptotic cells was significantly (32.9%) higher in plaques of PT of GDF-15-/-ApoE-/- than in ApoE-/-. Analysis of atherosclerotic lesion of a human pulmonary artery showed sm-α-actin, CD68+, TUNEL+, Ki67+, and APG5L/ATG+ cells as observed in PT. COX-2+ and IL-6+ immunoreactivities were predominantly located in endothelial cells and subendothelial space. In BT and PT of GDF15-/-ApoE-/- mice the necrotic area was 10% and 6.5% lower than in ApoE-/-. In BT and PT of GDF15-/-ApoE-/- we found 40% and 57% less unstable plaques than ApoE-/- mice. CONCLUSIONS Atherosclerotic lesions occur in both, BT and PT, however, the size is smaller in PT, possibly due to the effect of the low-oxygen blood and/or lower blood pressure. GDF-15 is involved in atherosclerotic processes in BT and PT, although different mechanisms (e.g. apoptosis) in these two vessels seem to exist.
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Affiliation(s)
- G A Bonaterra
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany.
| | - N Struck
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - S Zuegel
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - A Schwarz
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - L Mey
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - H Schwarzbach
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - J Strelau
- Department of Functional Neuroanatomy, University of Heidelberg, 69120, Heidelberg, Germany
| | - R Kinscherf
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
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Egom EEA. Natriuretic Peptide Clearance Receptor (NPR-C) Pathway as a Novel Therapeutic Target in Obesity-Related Heart Failure With Preserved Ejection Fraction (HFpEF). Front Physiol 2021; 12:674254. [PMID: 34093235 PMCID: PMC8176210 DOI: 10.3389/fphys.2021.674254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/12/2021] [Indexed: 01/08/2023] Open
Abstract
Heart failure (HF) with preserved ejection fraction (HFpEF) is a major public health problem with cases projected to double over the next two decades. There are currently no US Food and Drug Administration–approved therapies for the health-related outcomes of HFpEF. However, considering the high prevalence of this heterogeneous syndrome, a directed therapy for HFpEF is one the greatest unmet needs in cardiovascular medicine. Additionally, there is currently a lack of mechanistic understanding about the pathobiology of HFpEF. The phenotyping of HFpEF patients into pathobiological homogenous groups may not only be the first step in understanding the molecular mechanism but may also enable the development of novel targeted therapies. As obesity is one of the most common comorbidities found in HFpEF patients and is associated with many cardiovascular effects, it is a viable candidate for phenotyping. Large outcome trials and registries reveal that being obese is one of the strongest independent risk factors for developing HFpEF and that this excess risk may not be explained by traditional cardiovascular risk factors. Recently, there has been increased interest in the intertissue communication between adipose tissue and the heart. Evidence suggests that the natriuretic peptide clearance receptor (NPR-C) pathway may play a role in the development and pathobiology of obesity-related HFpEF. Therefore, therapeutic manipulations of the NPR-C pathway may represent a new pharmacological strategy in the context of underlying molecular mechanisms.
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Affiliation(s)
- Emmanuel Eroume A Egom
- Institut du Savoir Montfort, Hôpital Montfort, University of Ottawa, Ottawa, ON, Canada.,Laboratory of Endocrinology and Radioisotopes, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
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Abstract
Objective To elucidate the effect of diabetes mellitus (DM) on the atherosclerotic process in saphenous vein grafts by determining urotensin-II (U-II) levels in harvested saphenous veins of patients who underwent coronary artery bypass grafting (CABG). Methods Coronary artery disease (CAD) patients who underwent CABG were divided into two groups: Group I (eight non-diabetic patients; CAD group) and Group II (13 patients; DM+CAD group). All patients underwent coronary angiography prior to surgery and Gensini score was used to determine the severity of coronary atherosclerosis. Saphenous vein samples were stained with hematoxylin-eosin and U-II, then damage score, H-Score, and vein layer thicknesses were calculated and statistically evaluated. Results In light microscopic evaluation, significant difference was observed between the groups in terms of endothelial cells damage, internal elastic lamina degradation, and tunica media vascular smooth muscle cells (VSMCs) damage (P<0.001). U-II immunoreactivity was increased in tunica adventitia in the DM+CAD group (P=0.002). The increase in foam cells was directly proportional to the thickening of the subendothelial layer, and this increased U-II immunoreactivity. Gensini score was higher in the DM+CAD group than in the CAD group (P=0.002). Conclusion Our results show that saphenous vein grafts are already atherosclerotic before they are grafted in CAD patients. This disease is more severe in diabetic CAD patients and these changes can be detected using U-II immunoreactivity.
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Affiliation(s)
- Mehmet Erin Tüysüz
- Mersin City Training and Research Hospital Department of Cardiovascular Surgery Mersin Turkey Department of Cardiovascular Surgery, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Leyla Bahar
- Mersin University Vocational School Department of Medical Services and Techniques Mersin Turkey Department of Medical Services and Techniques of Vocational School, Mersin University, Mersin, Turkey
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8
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Bahar R, Dahl-Eriksen Ø, Busund R, Dahl PE, Hermansen SE, Iqbal A, Mannsverk JT, Myrmel T, Steigen TK, Trovik TS, Sørlie DG, Bartnes K. Direct angiography demonstrates equal 8-12 years patency rates of radial artery and saphenous vein grafts. SCAND CARDIOVASC J 2020; 54:330-335. [PMID: 32603197 DOI: 10.1080/14017431.2020.1784454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: The benefits of coronary artery bypass surgery depend on lasting graft patency. To aid rational graft selection, the relative long-term merits of radial artery and saphenous vein grafts need to be determined by a gold standard method and with minimal clinically driven selection bias. Methods: The patency rates of various conduits were determined by direct angiography in 76 patients from a cohort of 119 undergoing coronary artery bypass grafting 7.6-12.1 (mean 8.9) years before. Results: 14 out of 76 radial artery and 10 out of 61 saphenous vein grafts were occluded (rates 0.18 and 0.16, respectively). Conclusion: The high long-term patency rate of saphenous vein grafts does not support a preferential use of the radial artery as a coronary artery bypass conduit. Clinical registration number: ISRCTN23118170.
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Affiliation(s)
- Ramez Bahar
- Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromsø, Norway
| | | | - Rolf Busund
- Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromsø, Norway.,Institute of Clinical Medicine, University of Tromsø The Arctic University of Norway, Tromsø, Norway
| | - Per E Dahl
- Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromsø, Norway
| | - Stig E Hermansen
- Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromsø, Norway
| | - Amjid Iqbal
- Department of Cardiology, University Hospital North Norway, Tromsø, Norway
| | - Jan T Mannsverk
- Department of Cardiology, University Hospital North Norway, Tromsø, Norway
| | - Truls Myrmel
- Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromsø, Norway.,Institute of Clinical Medicine, University of Tromsø The Arctic University of Norway, Tromsø, Norway
| | - Terje K Steigen
- Department of Cardiology, University Hospital North Norway, Tromsø, Norway.,Institute of Clinical Medicine, University of Tromsø The Arctic University of Norway, Tromsø, Norway
| | - Thor S Trovik
- Department of Cardiology, University Hospital North Norway, Tromsø, Norway
| | - Dag G Sørlie
- Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromsø, Norway.,Institute of Clinical Medicine, University of Tromsø The Arctic University of Norway, Tromsø, Norway
| | - Kristian Bartnes
- Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromsø, Norway.,Institute of Clinical Medicine, University of Tromsø The Arctic University of Norway, Tromsø, Norway
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Smoking history increases the risk of long-term mortality after thoracic endovascular aortic repair in patients with an uncomplicated type B dissection. Chin Med J (Engl) 2020; 133:402-407. [PMID: 31977549 PMCID: PMC7046255 DOI: 10.1097/cm9.0000000000000640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: The preferred treatment for uncomplicated type B dissection (thoracic endovascular aortic repair [TEVAR] or medical) is still under debate. Since 2001, our center has performed TEVAR for uncomplicated type B dissection. Based on our data, 5- and 10-year survival rates among patients with uncomplicated type B dissection after TEVAR were 96.5% and 83.0%, respectively. We, therefore, believe that TEVAR is preferable for uncomplicated type B dissections. This study analyzed the impact of a pre-operative smoking history on long-term survival after TEVAR in patients with uncomplicated type B dissections. Methods: From May 2001 to December 2013, data from 751 patients with type B dissections were collected and analyzed. Patients were divided into two groups (337 smoking patients and 414 non-smoking patients). The Kaplan-Meier method and log-rank test were used to compare survival curves of the two groups. Multivariable analyses using the Cox proportional hazards model were used to estimate the effects of smoking on survival rates. Results: The 5- and 10-year survival rates of non-smokers were 97.6% (95% confidence interval [CI], 96.0%–99.2%) and 87.0% (95% CI, 81.6%–92.7%), respectively, and 94.9% (95% CI, 92.2%–97.7%) and 73.8% (95% CI, 62.3%–87.5%) for smokers, respectively (Log-rank test, P = 0.006). Multivariable analyses showed that smoking increased the risk of death during follow-up, 2.1-fold when compared to non-smokers (P = 0.039). Conclusion: A pre-operative smoking history increases long-term mortality rates after TEVAR in patients with uncomplicated type B dissections.
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10
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Liu Y, Li CP, Wang YY, Dong YN, Liu HW, Xiao JY, Gao MD, Wang JX, Li XW, Zhang N, Ma J, Gao J. Prediction of Major Adverse Cardiovascular Events and Slow/No-Reflow by Virtual Histology Imaging After Percutaneous Interventions on Saphenous Vein Grafts. Angiology 2019; 71:263-273. [PMID: 31867979 DOI: 10.1177/0003319719892354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Saphenous vein grafts disease (SVGD) is a common complication after coronary artery bypass graft (CABG) and usually treated by percutaneous coronary intervention (PCI). In this prospective cohort study, we performed virtual histology-intravascular ultrasound to investigate whether plaque composition and morphological characteristics were associated with post-PCI major adverse cardiac events (MACEs) and slow/no-reflow in patients with SVGD. Patients (n = 90) were studied (76.7% men, mean age 64.9 ± 8.2 years and mean duration of SVG 8.0 ± 3.6 years). There were 77.8% lesions with a plaque burden of at least 70%; 18 MACE incidences accumulated in 14 patients over 12 months post-PCI and slow/no-reflow was observed in 12 patients. On adjusted multivariate analysis, lesion length (hazard ratio [HR] = 1.05; 95% confidence interval [CI]: 1.01-1.08]); age of CABG (HR = 1.51 [95% CI: 1.11-2.05], and absolute necrotic core (NC) area (HR = 8.04 [95% CI: 1.86-34.73]) were independently associated with MACEs. Factors independently associated with slow/no-reflow post-PCI were preprocedure systolic blood pressure (odds ratio [OR] = 0.98; 95% CI: 0.96-0.99) and absolute NC area (OR = 2.47 (95% CI: 1.14-5.36). A cutoff value of absolute NC area at ≥1.1 mm2 may serve as a significant risk predictor for no-reflow after SVG-PCI. Factors associated with MACEs and the slow/no-reflow phenomenon following PCI of the SVG can be used in risk assessment of SVG.
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Affiliation(s)
- Yin Liu
- Department of Cardiology, Tianjin Chest Hospital, Jinnan, Tianjin, People's Republic of China
| | - Chang-Ping Li
- Tianjin Medical University, Heping, Tianjin, People's Republic of China
| | - Yue-Ying Wang
- Tianjin Medical University, Heping, Tianjin, People's Republic of China
| | - Ya-Nan Dong
- Tianjin Medical University, Heping, Tianjin, People's Republic of China
| | - Hong-Wei Liu
- Tianjin Medical University, Heping, Tianjin, People's Republic of China
| | - Jian-Yong Xiao
- Department of Cardiology, Tianjin Chest Hospital, Jinnan, Tianjin, People's Republic of China
| | - Ming-Dong Gao
- Department of Cardiology, Tianjin Chest Hospital, Jinnan, Tianjin, People's Republic of China
| | - Ji-Xiang Wang
- Department of Cardiology, Tianjin Chest Hospital, Jinnan, Tianjin, People's Republic of China
| | - Xiao-Wei Li
- Department of Cardiology, Tianjin Chest Hospital, Jinnan, Tianjin, People's Republic of China
| | - Nan Zhang
- Department of Cardiology, Tianjin Chest Hospital, Jinnan, Tianjin, People's Republic of China
| | - Jun Ma
- Tianjin Medical University, Heping, Tianjin, People's Republic of China
| | - Jing Gao
- Cardiovascular Institute, Tianjin Chest Hospital, Jinnan, Tianjin, People's Republic of China
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