可降解冠状动脉支架的研究进展

冠脉内支架植入是临床上预防PTCA术后再狭窄并发症的有效措施,但金属支架仅在植入早期发生作用,在冠脉内壁修复完成后则成为多余的负担,可能激活血小板及多种凝血因子聚集导致血栓形成及刺激血管壁造成心脏事件及再狭窄的发生。针对上述问题,生物可降解冠状动脉支架的研究得到了相当的发展。本文就可降解支架的发展及现状作一简要综述。     

Modification of coronary artery disease progression by cholesterol-lowering therapy: the angiographic studies

Large randomized placebo-controlled trials have demonstrated that cholesterol lowering with statin therapy reduces the incidence of adverse cardiac events. Smaller angiographic studies have shown that coronary artery disease progression can be slowed and, in some cases, reversed by cholesterol-lowering interventions. These anatomical changes, however, are small and occur too slowly to account for the early clinical benefit. Current evidence suggests that plaque stabilization is the most important mechanism, by which cholesterol-lowering therapy reduces both the incidence of adverse cardiac events and coronary artery disease progression.     

Twelve weeks of coronary artery disease.

Osler said the components of the student spirit are humility, confidence, pride and hope. In this retrospective look at 12 weeks spent on a cardiology ward, medical student Paul Fedak recounts his experiences concerning a patient diagnosed with terminal coronary artery disease.     

Different aspects of coronary artery disease

In the Netherlands, coronary-vascular disease is still the main cause of death with around 48,000 deaths each year. This means that one out of three deaths is due to coronary-vascular disease. Therefore knowledge of epidemiology, diagnosis and treatment (by medication, PCI or CABG) of vascular disease is of utmost importance. This issue of the Netherlands Heart Journal is dedicated to coronary artery disease and deals with several of its aspects, by means of interesting case reports and reports on imaging modalities.     

Oxidative status and reduced glutathione levels in premature coronary artery disease and coronary artery disease

Identifying patients at risk of developing premature coronary artery disease (PCAD) which occurs at age below 45 years old and constitutes approximately 7–10% of coronary artery disease (CAD) worldwide remains a problem. Oxidative stress has been proposed as a crucial step in the early development of PCAD. This study was conducted to determine the oxidative status of PCAD in comparison to CAD patients. PCAD (<45 years old) and CAD (>60 years old) patients were recruited with age-matched controls (n?=?30, each group). DNA damage score, plasma malondialdehyde (MDA) and protein carbonyl content were measured for oxidative damage markers. Antioxidants such as erythrocyte glutathione (GSH), oxidised glutathione (GSSG), and glutathione peroxidase activity (GPx), superoxide dismutase (SOD) and catalase (CAT) were also determined. DNA damage score and protein carbonyl content were significantly higher in both PCAD and CAD when compared to age-matched controls while MDA level was increased only in PCAD (p<.05). In contrast, GSH, GSH/GSSG ratio, α-tocotrienol isomer, and GPx activity were significantly decreased, but only in PCAD when compared to age-matched controls. The decrease in GSH was associated with PCAD (OR?=?0.569 95%CI [0.375???0.864], p?=?.008) and cut-off values of 6.69?μM with areas under the ROC curves (AUROC) 95%CI: 0.88 [0.80–0.96] (sensitivity of 83.3%; specificity of 80%). However, there were no significant differences in SOD and CAT activities in all groups. A higher level of oxidative stress indicated by elevated MDA levels and low levels of GSH, α-tocotrienol and GPx activity in patients below 45 years old may play a role in the development of PCAD and has potential as biomarkers for PCAD.