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8% in surgical group
37.0% in conservative group, P=0.041; (III) cardiac magnetic resonance (CMR) 22.4% in surgical group
14.8% in conservative group, P=0.579. At diagnosis, SVA diameters were TTE 4.80 cm (range, 3.30 cm); TEE 5.40 cm (range, 4.00 cm); MDCT 5.20 cm (range, 3.90 cm); CMR 4.80 cm (range, 3.70 cm).
In a 20-year cohort, proper selection for surgery and conservative management resulted in excellent outcomes for SVAs. TTE was the first-line imaging investigation for assessment of SVAs, although many patients underwent an additional imaging investigation. The contemporary outcomes of imaging-guided SVA management were excellent.
In a 20-year cohort, proper selection for surgery and conservative management resulted in excellent outcomes for SVAs. TTE was the first-line imaging investigation for assessment of SVAs, although many patients underwent an additional imaging investigation. The contemporary outcomes of imaging-guided SVA management were excellent.
Coronary computed tomography angiography (CCTA) combined with dynamic CT myocardial perfusion imaging (CT-MPI) and CCTA combined with CT fractional flow reserve (CT-FFR) are both expected to be efficient one-stop shop imaging strategies to guide clinical management. The aim of the study is to determine which of these two methods has superiority in terms of guiding treatment in patients with intermediate to high pretest probability of coronary artery disease (CAD).
CT-PRECISION (Computed Tomography myocardial PeRfusion imaging vErsus Computed tomography derived fractional flow reServe impact ON guiding treatment and prognosis in patients with intermediate to high pretest probability of CAD) is a multicenter, prospective, open-label, randomized study to directly compare the clinical value of guiding treatment and prognostic discrimination of CCTA + dynamic CT-MPI strategy and CCTA + CT-FFR strategy in patients with intermediate to high pretest probability of CAD. Four hundred and twelve patients will be enrstered at Chinese Clinical Trial Registry (ChiCTR) with the identifier number ChiCTR2000041102. The first enrollment is planned for January 2021.
The study is registered at Chinese Clinical Trial Registry (ChiCTR) with the identifier number ChiCTR2000041102. The first enrollment is planned for January 2021.
The purpose of this study was to explore the role of protein kinase C (PKC) isozymes and reactive oxygen species (ROS) in hypoxia and angiotensin (Ang) II-induced autophagy.
Primary cardiomyocytes were isolated from Sprague-Dawley (SD) neonatal rats and cultured in hypoxia and/or Ang II conditions. Dihydroethidium fluorescence staining was used to detect the content of ROS. Cardiomyocyte autophagy was determined using Monodansylcadaverine fluorescence staining and Western blot. We also inhibited ROS production to explore the relationship between ROS and autophagy. learn more ELISA was used to detect the contents of PKC δ and PKC ε. After inhibition of PKC δ activation and PKC ε expression by lentiviral siRNA, ROS content and autophagy of cultured cardiomyocytes were detected.
Hypoxia and Ang II stimulation increased autophagy in cardiomyocytes, accompanied by increased intracellular ROS production. Inhibiting ROS following hypoxia or Ang II stimulation significantly suppressed autophagy in comparison with hypoxia or Ang II stimulation group. Inhibiting PKC δ significantly reduced ROS production and autophagy activity following hypoxia or accompanied with Ang II stimulation except Ang II stimulation alone. Knockdown of PKC ε notably decreased ROS production and autophagy in response to Ang II alone and in combination with hypoxia rather than hypoxia alone.
Both hypoxia and Ang II stimulation can induce autophagy in cardiomyocytes through increasing intracellular ROS. However, hypoxia and Ang II stimulation induced myocardial autophagy via PKC δ and PKC ε, respectively.
Both hypoxia and Ang II stimulation can induce autophagy in cardiomyocytes through increasing intracellular ROS. However, hypoxia and Ang II stimulation induced myocardial autophagy via PKC δ and PKC ε, respectively.
Traditional prognostic risk assessment in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) is based on a limited selection of clinical and imaging findings. Machine learning (ML) can consider a higher number and complexity of variables and may be useful for characterising cardiovascular risk, predicting outcomes, and identifying biomarkers in large population studies.
We prospectively enrolled 9,680 consecutive patients with coronary artery disease who underwent PCI at our institution between January 2013 and December 2013. Clinical features were selected and used to train 6 different ML models (support vector machine, decision tree, random forest, gradient boosting decision tree, neural network, and logistic regression) to predict cardiovascular outcomes, 10-fold cross-validation to evaluate the performance of models.
During the 5-year follow-up, 467 (4.82%) patients died. Eighty-seven risk baseline measurements were used to train ML models. Compared with the other models, the random forest model (RF-PCI) exhibited the best performance on predicting all-cause mortality (area under the receiver operating characteristic curve 0.71±0.04). Calibration plots demonstrated a slight overprediction for patients using the RF-PCI model (Hosmer-Lemeshow test P>0.05). The top 15 features related to PCI candidates' long-term prognosis, among which 11 were laboratory measures.
ML models improved the prediction of long-term all-cause mortality in patients with coronary artery disease before PCI. The performance of the RF model was better than that of the other models, providing a meaningful stratification.
ML models improved the prediction of long-term all-cause mortality in patients with coronary artery disease before PCI. The performance of the RF model was better than that of the other models, providing a meaningful stratification.
Randomised controlled trials have shown diverse results for radial access in patients undergoing primary percutaneous coronary intervention (PPCI). Moreover, it is questionable whether radial access improves outcome in patients with cardiogenic shock undergoing PPCI. We aimed to investigate the outcome according to access site in patients with or without cardiogenic shock, in daily clinical practice.
For the present analysis we included 9,980 patients undergoing PPCI between 2012 and 2018, registered in the multi-centre, nationwide registry on PCI for myocardial infarction (MI). In-hospital mortality, major adverse cardiovascular events (MACE), and net adverse clinical events (NACE) until discharge were compared between 4,498 patients with radial (45%) and 5,482 patients with femoral (55%) access.
Radial compared to femoral access was associated with lower in-hospital mortality (3.5%
7.7%; P<0.01). Multivariable logistic regression analysis confirmed reduced in-hospital mortality [odds ratio (OR) 0.
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