Drug-coated balloons for the treatment of ostial left anterior descending or ostial left circumflex artery lesions:a patientlevel propensity score-matched analysis

BACKGROUND Controversy exists as to the optimal treatment approach for ostial left anterior descending(LAD)or ostial left circumflex artery(LCx)lesions.Drug-coated balloons(DCB)may overcome some of the limitations of drug-eluting stents(DES).Therefore,we investigated the security and feasibility of the DCB policy in patients with ostial LAD or ostial LCx lesions,and compared it with the conventional DES-only strategy.METHODS We retrospectively enrolled patients with de novo ostial lesions in the LAD or LCx who underwent interventional treatment.They were categorized into two groups based on their treatment approach:the DCB group and the DES group.The treatment strategies in the DCB group involved the use of either DCB-only or hybrid strategies,whereas the DES group utilized crossover or precise stenting techniques.Two-year target lesion revascularization was the primary endpoint,while the rates of major adverse cardiovascular events,cardiac death,target vessel myocardial infarction,and vessel thrombosis were the secondary endpoints.Using propensity score matching,we assembled a cohort with comparable baseline characteristics.To ensure result analysis reliability,we conducted sensitivity analyses,including interaction,and stratified analyses.RESULTS Among the 397 eligible patients,6.25%of patients who were planned to undergo DCB underwent DES.A total of 108 patients in each group had comparable propensity scores and were included in the analysis.Two-year target lesion revascularization occurred in 5 patients(4.90%)and 16 patients(16.33%)in the DCB group and the DES group,respectively(odds ratio=0.264,95%CI:0.093–0.752,P=0.008).Compared with the DES group,the DCB group demonstrated a lower major adverse cardiovascular events rate(7.84%vs.19.39%,P=0.017).However,differences with regard to cardiac death,non-periprocedural target vessel myocardial infarction,and definite or probable vessel thrombosis between the groups were non-significant.CONCLUSIONS The utilization of the DCB approach signifies an innovative and discretionary strategy for managing isolated ostial lesions in the LAD or LCx.Nevertheless,a future randomized trial investigating the feasibility and safety of DCB compared to the DES-only strategy specifically for de novo ostial lesions in the LAD or LCx is highly warranted.

Expression heterogeneity research of ITGB3 and BCL-2 in lung adenocarcinoma tissue and adenocarcinoma cell line

Objective:To analyze expression heterogeneity of Integrin beta 3(ITCB3) and B-cell lymphoma2(BCL-2) in lung adenocarcinoma tissue and adenocarcinoma cell line and further provide theoretical direction for molecular biological research of lung adenocarcinoma.Methods:Tissue microarray was used to observe relation among expression,heterogeneitpy and clinical characteristics of ITGB3 and BCL-2 in lung cancer.Results:ITGB3 and BCL-2 increased significantly in A549 cells in CAFs group with β-actin as control:the expression level of BCL-2also increased in 1TGB3 transfected cells with CFP plasmid transfected A549 cells as control:immunohistochemistry staining showed that positive ratcs of 1TGB3,ITGB1 and BCL-2 in normal lung tissues were 0.the positive rates in lung adenocarcinoma were 7.049%,84.51%and 4.23%,respectively:in the results of immunohistochemistrv staining,the expression of Girdin protein in lung adenocarcinoma was homogeneous,however protein expression of 1TCB3,ITGB1 and BCL—2showed different patterns in the same location with significant heterogeneity;majority of ITGB3,TTCB1 or BCL—2 positive tissue showed heterogeneity that expression in trailing edge was higher than that of trailing edge in lung adenocarcinoma tissue,the patients with BCL-2 heterogeneity showed higher lymph node metastasis ratio and lower clinical stage(P<0.05);and the expression of ITGB3 and the clinical characteristics of patients were not significant related(P>0.05).Conclusions:Expression of ITGB3 and BCL-2 in lung adenocarcinoma and adenocarcinoma cell line showed heterogeneity that expression in trailing edge was higher than that of trailing edge,which may play an important role in promoting tumor lymph node metastasis and vascular invasion,and provides a new research direction for exploration of lung adenocarcinoma metastasis mechanism.