Notes

The actual GPI-anchored health proteins CD109 shields hematopoietic progenitor cellular material via considering erythroid differentiation induced simply by TGF-β.
BACKGROUND We aimed to demonstrate the prognostic value of Selvester QRS scores in patients with acute ST-segment elevation myocardial infarction (STEMI). METHODS In this prospective, observational study, we screened 289 patients with acute STEMI who underwent percutaneous coronary intervention (PCI) from 1 January 2014 to 1 June 2015 at the Second Hospital of Dalian Medical University. FTY-720 in vitro Selvester QRS scores were calculated at the time of hospital admission and within 24 h after treatment for PCI. The primary endpoint was the 2-year mortality rate, and the secondary endpoint was any nonfatal major adverse cardiovascular event (MACE). RESULTS Of the 289 patients, the QRS score increased in 115 (39.8%), and the 2-year mortality and MACE rates were significantly higher in these patients than in those in whom the QRS score decreased or remained unchanged after the treatment of PCI. Multivariable Cox regression analysis revealed that both baseline QRS scores and changes in QRS scores were independently associated with the 2-year mortality rate [hazard ratio (HR) 1.462, 95% confidence interval (95% CI) 1.279-1.671 and HR 5.122, 95% CI 2.128-12.328, respectively), MACE rate (HR 1.119, 95% CI 1.019-1.229 and HR 2.585, 95% CI 1.260-5.303, respectively) and composite endpoint (HR 1.137, 95% CI 1.047-1.236 and HR 3.152, 95% CI 1.704-5.829, respectively) after adjusting for other risk factors. CONCLUSION In conclusion, both baseline Selvester QRS scores and changes in QRS scores independently predicted poor outcomes in patients with acute STEMI who underwent PCI.BACKGROUND Acute anterior ST-segment elevation myocardial infarction (STEMI) is a life-threatening disease. Adverse cardiac events of acute anterior STEMI include cardiovascular death or worsening congestive heart failure. link2 This study investigated the role of fragmented QRS complex (fQRS) in predicting insufficient ejection fraction (EF) recovery in acute anterior STEMI. METHODS Patients with acute anterior STEMI who received thrombolytic therapy were prospectively enrolled in this study. Twelve-lead electrocardiography (ECG) was obtained from all patients during admission and 24 and 48 h after admission. We divided the patients into two groups according to the presence of fQRS appearance within 48 h absence of fQRS in any lead (fQRS-), and its presence in two or more contiguous leads (fQRS+). All patients were evaluated with transthoracic echocardiography at admission, and at follow-up 6 and 12 months later. RESULTS A total of 138 consecutive patients were included in the study. Seventy-three patients (52.9%) had fQRS in the ECG. EF recovery in the fQRS(+) group was significantly lower than that of the fQRS(-) group (39% vs. 43.9%, P less then 0.001). Multiple logistic regression analysis showed that the fQRS (odds ratio 4.147, 95% confidence interval 1.607-10.697, P = 0.003) were an independent predictor of poor EF recovery. CONCLUSION The presence of fQRS is an independent predictor for inadequate EF recovery in acute anterior STEMI patients undergoing thrombolytic treatment. Assessment of fQRS on surface ECG may be used in determining high-risk patients for poor EF recovery after acute anterior STEMI.OBJECTIVE Fibrinogen-to-albumin ratio (FAR) is an inexpensive and easily measurable novel inflammatory index that has been found to be associated with atherosclerosis. In this study, we aimed to investigate the association between the FAR and coronary artery disease (CAD) severity in patients with stable CAD. METHODS In total, 356 consecutive patients with CAD were classified into three groups, those with a low Synergy between percutaneous coronary intervention and the Taxus and Cardiac Surgery Study (SYNTAX) score (≤22), those with an intermediate SYNTAX score (23≥ SYNTAX score ≤32) and those with a high SYNTAX score (>32). RESULTS We determined that there were significant differences in the mean age (P  less then  0.001), male gender (P = 0.008), serum fibrinogen (P = 0.03), low-density lipoprotein cholesterol (P  less then  0.001) and FAR (P  less then  0.001) among the SYNTAX score groups. A strong positive correlation was detected between FAR and SYNTAX score (r = 0.899; P  less then  0.001), and the cutoff level of FAR for high SYNTAX score was 82 (sensitivity of 82%, specificity of 88.3% and an area under the curve of 0.826). CONCLUSION The novel inflammatory index, FAR, is significantly associated with the severity of CAD in patients with stable CAD.BACKGROUND Chronic total occlusion intervention remains challenging and detailed real-world data on the safety and efficacy of which are limited. This study sought to determine whether there are differences in the 1-year clinical outcomes between chronic total occlusion patients with acute coronary syndrome and stable angina following chronic total occlusion intervention. PATIENTS AND METHODS Data from the Korean chronic total occlusion registry were collected from May 2003 to September 2012, and a total of 3268 patients who underwent chronic total occlusion intervention were enrolled. Cardiovascular outcomes up to 12 months in the acute coronary syndrome group were compared with stable angina group. RESULTS The acute coronary syndrome group consisted of 1657 patients, and stable angina group consisted of 1264 patients. In the acute coronary syndrome group, patients with successful chronic total occlusion intervention had a lower incidence of total death and cardiac death compared to patients with failed intervention. However, there were no significant differences in cardiovascular events in the stable angina group. The successful chronic total occlusion intervention was a significant prognostic factor for lower total death (P = 0.006, hazard ratio = 0.46) and cardiac death (P = 0.003, hazard ratio = 0.36) within acute coronary syndrome group. On the other hand, successful chronic total occlusion intervention was not a prognostic factor for cardiovascular events within stable angina group. CONCLUSIONS Successful chronic total occlusion intervention in acute coronary syndrome patients was associated with a lower incidence of cardiovascular outcome compared to patients with failed chronic total occlusion intervention.BACKGROUND Cardiac rupture is a disastrous but uncommon complication of acute ST-elevation myocardial infarction (STEMI). The incidence, risk factors and in-hospital outcomes related to cardiac rupture in the current era are unknown. METHODS This study consecutively collected all acute STEMI patients admitted to a single tertiary center in China from January 2004 to December 2015. Characteristics of each cardiac rupture were collected and analyzed. RESULTS Among 4190 patients, 75 (1.8%) patients had cardiac rupture, including 33 at the ventricular septum and 42 at the left ventricle free wall (LVFW). Patients with cardiac rupture were more likely to be female, with more advanced age, lower rate of primary percutaneous coronary intervention (PPCI), and higher in-hospital mortality. Compared with survivors, the death cases were older, had a higher white blood cell count, higher rate of delayed admission (>12 h from symptom onset to door), earlier occurrence of cardiac rupture, higher percentage of LVFW rupture and lower rate of surgical repair. Logistic regression analysis showed that surgical repair served as the most valuable factor affecting survival. Moreover, elevated white blood cell count and advanced age might be related to an increased in-hospital death due to cardiac rupture. CONCLUSIONS In this contemporary cohort, female sex, advanced age and low rate of PPCI post-STEMI are associated with an increased risk of cardiac rupture. Advanced age and elevated white blood cell count might be related to an increased in-hospital mortality after cardiac rupture, whereas surgical repair served as the most valuable factor affecting survival.BACKGROUND Transplant recipients experience excess cardiac mortality. We compared cardiac death rates in Australian and New Zealand kidney transplant recipients to the general population and identified risk factors for cardiac death in kidney transplant recipients. METHODS Primary cause of death for kidney transplant recipients aged ≥18 was established through ICD-10-AM codes using data linkage between the Australia and New Zealand dialysis and transplant registry and national death registers. We estimated standardised mortality ratios (SMR) and developed a Fine-Gray competing risks model to determine risk factors for cardiac mortality. RESULTS Of 5089 deaths in 16 329 kidney transplant recipients (158 325 person-years), 918(18%) were cardiac. Increased risk of cardiac death was associated with older age(p less then 0.001), male sex(p less then 0.001), longer dialysis duration(p=0.004), earlier era of transplantation(p less then 0.001), ever graft failure(p less then 0.001), known coronary artery disease(p=0.002) and kidney failure from diabetes or hypertension(p less then 0.001). link3 The cardiac SMR was 5.4(95%CI5.0,5.8), falling from 8.0(95%CI4.9,13.1) in 1988 to 5.3(95%CI4.0,7.0) in 2013(p less then 0.001). Females, particularly young females, had significantly higher relative cardiac mortality than men. In recipients aged 40 years, the cardiac SMR was 26.5(95%CI15.0,46.6) in females and 7.5(95%CI5.0,11.1) for males. CONCLUSIONS Cardiac risks remain elevated in kidney transplant recipients and may be under-recognized, and/or prevention and treatment interventions less accessed, less effective or even harmful in female recipients.BACKGROUND Machine perfusion (MP) has evolved as a promising approach for the ex situ preservation in organ transplantation. However, the literature on the use of MP in human vascularized composite allografts (VCA) is scarce. The aim of this study was to evaluate the effects of hypothermic MP with an acellular perfusate in human upper extremities and compare with the current gold standard of static cold storage (SCS). METHODS Six upper extremities were assigned to either MP (n=3) or SCS (n=3) conditions for 24 hours. MP-extremities were perfused with oxygenated Steen™ solution at a constant pressure of 30mmHg and 10°Celsius. RESULTS Median total ischemia time was 213 minutes (range, 127 to 222 minutes). Myoglobin, creatine-kinase (CK) showed increased levels at the start of MP (medians myoglobin 4377ng/ml, CK 1442U/L), peaking 6 hours after perfusate exchange (medians myoglobin 9206ng/ml, CK 3995U/L) at timepoint 24. Lactate levels decreased from a median of 6.9mmol/L to 2.8mmol/L over time. Expression of HIF-1α peaked in the SCS-group after 8h, followed by a decrease. Increased HIF-1α expression in the MP-group was delayed until 20h. Perfusion pressure, temperature and circuit flow were maintained at median of 30.88mmHg, 9.77°Celsius, and 31.13ml/min, respectively. Weight increased 1.4% in the SCS- and 4.3% in the MP-group over 24h. CONCLUSIONS Hypothermic ex situ perfusion with an oxygenated acellular Steen™ solution may extend the allowable extracorporeal preservation time by a factor of 4-6 compared to static cold storage and holds promise to be beneficial for VCA recipients and victims of traumatic major limb amputation.OBJECTIVES The aim of this study was to clinically validate a Deep Convolutional Neural Network (DCNN) for the detection of surgically proven anterior cruciate ligament (ACL) tears in a large patient cohort and to analyze the effect of magnetic resonance examinations from different institutions, varying protocols, and field strengths. MATERIALS AND METHODS After ethics committee approval, this retrospective analysis of prospectively collected data was performed on 512 consecutive subjects, who underwent knee magnetic resonance imaging (MRI) in a total of 59 different institutions followed by arthroscopic knee surgery at our institution. The DCNN and 3 fellowship-trained full-time academic musculoskeletal radiologists evaluated the MRI examinations for full-thickness ACL tears independently. Surgical reports served as the reference standard. Statistics included diagnostic performance metrics, including sensitivity, specificity, area under the receiver operating curve ("AUC ROC"), and kappa statistics. P values less than 0.
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