Background Circulating microparticles （MPs） have been reported to be associated with coronary artery disease （CAD）. In this study, we explored the relationship between MPs procoagulant activity and characteristics...Background Circulating microparticles （MPs） have been reported to be associated with coronary artery disease （CAD）. In this study, we explored the relationship between MPs procoagulant activity and characteristics of atherosclerotic plaque detected by 64-slice computed tomography angiography （CTA）. Methods In 127 consecutive patients with CAD but without acute coronary syndrome and who under went 64-slice CTA, MPs procoagulant activity in plasma Coy a thrombin generation test）, soluble form of lectin-like oxidized low-density lipoprotein receptor-1 （sLOX-1） and N（epsilon）-（carboxymethyl） lysine （CML） circulating levels （by ELISA） were measured. A quantitative volumetric analysis of the lumen and plaque burden of the vessel wall （soft and calcific components）, for the three major coronary vessels, was performed. The patients were classified in three groups according to the presence of calcium volume： non-calcified plaque （NCP） group （calcium volume （%） = 0）, moderate calcified plaque （MCP） group （0 〈 calcium volume （%） 〈 1）, and calcified plaque （CP） group （calcium volume （%） 〉 1）. Results MPs procoagulant activity and CML levels were higher in MCP group than in CP or NCP group （P = 0.009 and P = 0.027, respectively）. MPs procoagulant activity was positively associated with CML （r = 0.317, P 〈 0.0001） and sLOX-1 levels （r = 0.216, P = 0.0025）. Conclusions MPs procoagulant activity was higher in the MCP patient group and correlated positively with sLOX-1 and CML levels, suggesting that it may characterize a state of blood vulnerability that may locally precipitate plaque instability and increase the risk of subsequent major cardiovascular events.展开更多
Background Although radial access for drug-eluting stent （DES） combined with rotational atherectomy （RA） in patients with calcified coronary lesions may be associated with a lower risk of major bleeding complicati...Background Although radial access for drug-eluting stent （DES） combined with rotational atherectomy （RA） in patients with calcified coronary lesions may be associated with a lower risk of major bleeding complications and obtain favorable clinical results compared with femoral access, the long-term outcome data of this approach were limited in contemporary DES era. Methods ＆ Results This retrospective study sought to compare in-hospital and long-term outcomes for patients undergoing RA via the transradial （TR） and transfemoral （TF） route in 126 consecutive patients （59 radial, 67 femoral） from 2009 to 2014. TR RA procedures were performed in 44/62 （71%） by the three TR operators, compared with 15/64 （23%） by the four TF operators in the present study. Significantly smaller diameter guide catheters and burrs （1.39 ± 0.16 mm vs. 1.53 ± 0.24 mm, P = 0.001） were used in the TR group. Procedural success rates were similar in both TR and TF groups. There was a significantly less major access site bleeding complications in favor of radial artery access （2% vs. 16%, P = 0.012）. The incidence of in-hospital death or myocardial infarction was low in both groups. Although a trend of lower adverse event rate was demonstrated in the TR group compared with the TF one, no statistical significance （21% vs. 27%, P = 0.135） was detected. Conclusions Radial access, a useful alternative to femoral access for RA and DES, can be safely and successfully performed on up to 71% of the patients with heavily calcified coronary lesions needing RA by experienced TR operators.展开更多
文摘Background Circulating microparticles （MPs） have been reported to be associated with coronary artery disease （CAD）. In this study, we explored the relationship between MPs procoagulant activity and characteristics of atherosclerotic plaque detected by 64-slice computed tomography angiography （CTA）. Methods In 127 consecutive patients with CAD but without acute coronary syndrome and who under went 64-slice CTA, MPs procoagulant activity in plasma Coy a thrombin generation test）, soluble form of lectin-like oxidized low-density lipoprotein receptor-1 （sLOX-1） and N（epsilon）-（carboxymethyl） lysine （CML） circulating levels （by ELISA） were measured. A quantitative volumetric analysis of the lumen and plaque burden of the vessel wall （soft and calcific components）, for the three major coronary vessels, was performed. The patients were classified in three groups according to the presence of calcium volume： non-calcified plaque （NCP） group （calcium volume （%） = 0）, moderate calcified plaque （MCP） group （0 〈 calcium volume （%） 〈 1）, and calcified plaque （CP） group （calcium volume （%） 〉 1）. Results MPs procoagulant activity and CML levels were higher in MCP group than in CP or NCP group （P = 0.009 and P = 0.027, respectively）. MPs procoagulant activity was positively associated with CML （r = 0.317, P 〈 0.0001） and sLOX-1 levels （r = 0.216, P = 0.0025）. Conclusions MPs procoagulant activity was higher in the MCP patient group and correlated positively with sLOX-1 and CML levels, suggesting that it may characterize a state of blood vulnerability that may locally precipitate plaque instability and increase the risk of subsequent major cardiovascular events.
文摘Background Although radial access for drug-eluting stent （DES） combined with rotational atherectomy （RA） in patients with calcified coronary lesions may be associated with a lower risk of major bleeding complications and obtain favorable clinical results compared with femoral access, the long-term outcome data of this approach were limited in contemporary DES era. Methods ＆ Results This retrospective study sought to compare in-hospital and long-term outcomes for patients undergoing RA via the transradial （TR） and transfemoral （TF） route in 126 consecutive patients （59 radial, 67 femoral） from 2009 to 2014. TR RA procedures were performed in 44/62 （71%） by the three TR operators, compared with 15/64 （23%） by the four TF operators in the present study. Significantly smaller diameter guide catheters and burrs （1.39 ± 0.16 mm vs. 1.53 ± 0.24 mm, P = 0.001） were used in the TR group. Procedural success rates were similar in both TR and TF groups. There was a significantly less major access site bleeding complications in favor of radial artery access （2% vs. 16%, P = 0.012）. The incidence of in-hospital death or myocardial infarction was low in both groups. Although a trend of lower adverse event rate was demonstrated in the TR group compared with the TF one, no statistical significance （21% vs. 27%, P = 0.135） was detected. Conclusions Radial access, a useful alternative to femoral access for RA and DES, can be safely and successfully performed on up to 71% of the patients with heavily calcified coronary lesions needing RA by experienced TR operators.
