Domestic versus imported drug-eluting stents for the treatment of patients with acute coronary syndrome

The association between an endothelial nitric oxide synthase gene polymorphism and coronary heart disease in young people and the underlying mechanism

With the development of molecular biological technology, the association between genes and diseases has drawn increasing attention of researchers; the endothelial nitric oxide synthase (eNOS) gene has been reported to be a candidate gene for cardiovascular disease (CHD). The present study aimed to investigate the association between a polymorphism of eNOS and the risk of CHD in young people (≤40 years old), in addition to the underlying mechanism. A total of 234 cases of CHD in young individuals were collected as the CHD group and 228 cases of healthy individuals as the control group. Peripheral blood was collected and the genotype of the eNOS G894T polymorphism was identified by polymerase chain reaction-restriction fragment length polymorphism, the gene frequency was calculated and the distributions of genotype and allele frequency between the two groups were compared. Bioinformatics tools were employed to analyze the differences in the local protein structures of the eNOS G894T polymorphism and the biological mechanism was preliminary discussed. The results demonstrated that there were significant differences in the distribution of genotype frequency and allele frequency of the eNOS G894T gene polymorphism between the CHD group and control group (P<0.05). The risk of CHD in GT and TT genotypes were higher compared with the GG genotype (P<0.05). The G894T polymorphism led to Glu298Asp mutation of encoded protein, which is within the active site of eNOS, and partial structures of the protein were converted from random coil to α‑helix. In conclusion, the eNOS G894T gene polymorphism was associated with the occurrence and development of CHD in young people. The potential mechanism is that the G894T polymorphism leads to altered protein structure, which affects the function of eNOS in generating nitric oxide and cardiovascular diastole. The results of the present study suggested a potential target gene for the prevention and treatment of CHD in young people (≤40 years old).

Clinical comparison of percutaneous coronary intervention with domestic drug-eluting stents versus off pump coronary artery bypass grafting in unprotected left main coronary artery disease

OBJECTIVE

The aim of our study was to compare the clinical outcomes of percutaneous coronary intervention (PCI) with domestic drug-eluting stents (DES) and off pump coronary artery bypass grafting (CABG) for the treatment of unprotected left main coronary artery (ULMCA) disease.

METHODS

A total of 227 patients with ULMCA disease and underwent revascularization was included. One hundred and six patients were treated with PCI with domestic DES implantation and 121 patients with off pump CABG. Clinical outcomes with respect to the major adverse cardiovascular and cerebrovascular events (MACCE) including death any cause, non-fatal myocardial infarction (MI), stroke, and target vessel revascularization (TVR) during hospitalization and at 12-month follow-up were recorded.

RESULTS

There was no significant difference between the domestic DES and off pump CABG groups in the risk of death, non-fatal MI, stroke, and TVR during hospitalization and at 12-month follow-up. Overall in-hospital MACCE in PCI versus CABG was 0.94% versus 5.78% (P<0.05). The overall MACCE at 12-month follow up in PCI versus CABG was in 3.77% versus 3.31% (P>0.05).

CONCLUSIONS

Domestic DES is feasible and safety in the treatment of ULMCA lesions. When compared with off-pump CABG, domestic DES achieved similar completeness of revascularization, similar in-hospital and 12-month follow-up outcomes. A longer follow-up is needed.