Discordance of Low-Density Lipoprotein Cholestrol and Non-High-Density Lipoprotein Cholestrol and Coronary Artery Disease Severity.
- 作者列表："Kurmus O","Erkan AF","Ekici B","Aslan T","Eren M
BACKGROUND:A sizeable proportion of patients have discordant low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C). OBJECTIVES:We assessed the relationship between discordance of LDL-C and non-HDL-C and coronary artery disease (CAD) severity. METHODS:We retrospectively evaluated the data of 574 consecutive patients who underwent coronary angiography. Fasting serum lipid profiles were recorded, SYNTAX and Gensini scores were calculated to establish CAD complexity and severity. We determined the medians for LDL-C and non-HDL-C to examine the discordance between LDL-C and non-HDL-C. Discordance was defined as LDL-C greater than or equal to the median and non-HDL-C less than median; or LDL-C less than median and non-HDL-C greater than or equal to median. A p value < 0.05 was accepted as statistically significant. RESULTS:LDL-C levels were strongly and positively correlated with non-HDL-C levels (r = 0.865, p < 0.001) but 15% of patients had discordance between LDL-C and non-HDL-C. The percentage of patients with a Gensini score of zero or SYNTAX score of zero did not differ between discordant or concordant groups (p = 0.837, p = 0.821, respectively). Mean Gensini and SYNTAX scores, percentage of patients with Gensini score ≥20 and SYNTAX score >22 were not different from group to group (p = 0.635, p = 0.733, p = 0.799, p = 0.891, respectively). Also, there was no statistically significant correlation between LDL-C and Gensini or SYNTAX scores in any of the discordant or concordant groups. Additionally, no correlation was found between non-HDL-C and Gensini or SYNTAX score. CONCLUSIONS:While there was discordance between LDL-C and non-HDL-C (15% of patients), there is no difference regarding CAD severity and complexity between discordant and concordant groups.
背景: 相当比例的患者具有不一致的低密度脂蛋白胆固醇 (ldl-c) 和非高密度脂蛋白胆固醇 (non-hdl-c)。 目的: 我们评估了ldl-c和非hdl-c的不一致性与冠状动脉疾病 (CAD) 严重程度之间的关系。 方法: 回顾性分析574例冠状动脉造影患者的临床资料。记录空腹血脂谱，计算SYNTAX和Gensini评分以确定CAD的复杂性和严重程度。我们确定了ldl-c和非hdl-c的中位数，以检查ldl-c和非hdl-c之间的不一致性。不一致定义为ldl-c大于或等于中位数，非hdl-c小于中位数; 或ldl-c小于中位数，非hdl-c大于或等于中位数。P值 <0.05被认为是统计学上显著的。 结果: ldl-c水平与非hdl-c水平呈显著正相关 (r = 0.865，p <0.001)，但15% 的患者存在ldl-c与非hdl-c的不一致。Gensini评分为零或SYNTAX评分为零的患者百分比在不一致或一致组之间没有差异 (分别为p = 0.837，p = 0.821)。平均Gensini和SYNTAX评分、Gensini评分 ≥ 20和SYNTAX评分> 22的患者百分比在组间无差异 (分别为p = 0.635，p = 0.733，p = 0.799，p = 0.891)。此外，在任何不一致或一致的组中，ldl-c与Gensini或SYNTAX评分之间没有统计学上显著的相关性。此外，未发现非hdl-c与Gensini或SYNTAX评分之间的相关性。 结论: 尽管ldl-c和非hdl-c之间存在不一致 (15% 的患者)，但不一致组和非一致组之间在CAD严重程度和复杂性方面没有差异。
METHODS::We present the case of a 61-year-old woman with a large tumoral infiltration extending from the pelvis throughout the inferior vena cava inferior to the right atrium, protruding into the right ventricle and right ventricular outflow tract. She had been treated 10 years before for low-grade endometrial stromal sarcoma by hysterectomy and adnexectomy followed by hormone- and radio-therapy. Due to cancer recurrence, she underwent peritonectomy, appendectomy, and resection of terminal ileum.
METHODS:AIMS:Significant platelet activation after long stented coronary segments has been associated with periprocedural microvascular impairment and myonecrosis. In long lesions treated either with an everolimus-eluting bioresorbable vascular scaffold (BVS) or an everolimus-eluting stent (EES), we aimed to investigate (a) procedure-related microvascular impairment, and (b) the relationship of platelet activation with microvascular function and related myonecrosis. METHODS AND RESULTS:Patients (n=66) undergoing elective percutaneous coronary intervention (PCI) in long lesions were randomised 1:1 to either BVS or EES. The primary endpoint was the difference between groups in changes of pressure-derived corrected index of microvascular resistance (cIMR) after PCI. Periprocedural myonecrosis was assessed by high-sensitivity cardiac troponin T (hs-cTnT), platelet reactivity by high-sensitivity adenosine diphosphate (hs-ADP)-induced platelet reactivity with the Multiplate Analyzer. Post-dilatation was more frequent in the BVS group, with consequent longer procedure time. A significant difference was observed between the two groups in the primary endpoint of ΔcIMR (p=0.04). hs-ADP was not different between the groups at different time points. hs-cTnT significantly increased after PCI, without difference between the groups. CONCLUSIONS:In long lesions, BVS implantation is associated with significant acute reduction in IMR as compared with EES, with no significant interaction with platelet reactivity or periprocedural myonecrosis.
METHODS:BACKGROUND:Aortopulmonary window is an uncommon congenital heart disease, with untreated cases not surviving beyond childhood. However, very rarely it can present in adult patients with features of pulmonary hypertension. Clinically these patients cannot be differentiated from other more common conditions with left to right shunt. Transthoracic echocardiography if performed meticulously, can depict the defect in aortopulmonary septum. RESULTS:We report a case of large unrepaired aortopulmonary window in a 23 years old patient, diagnosed on transthoracic echocardiography.