Circulating thrombotic and haemostatic components in patients with coronary artery disease

The study aimed to analyze the circulating levels of thrombotic and haemostatic components; tissue factor, tissue factor pathway inhibitor, tissue plasminogen activator and plasminogen activator inhibitor-1 in patients with acute myocardial infarction at presentation (Group 1, n=49), unstable angina and Non-ST elevated MI after treatment (Group 2, n=22), stable angina (Group 3, n=18) and healthy individuals (Group 4, n=31). Significant finding was increase in tissue factor not only in Group 1 (2.0 fold, P=0.001), Group 2 (2.2 fold, P=0.015) but also in Group 3 (1.8 fold, P=0.018) as compared to controls. In Group 1 Plasminogen activator inhibitor-1 increased significantly (35.8%, P=0.02). Tissue factor pathway inhibitor and tissue plasminogen activator demonstrated increase in Group 1 of age<40 years while insignificant changes in elder patients. Increased thrombotic and decreased fibrinolytic conditions in acute myocardial infarction patients were observed. Increase TF in stable angina demonstrates procoagulant status in these patients as well.     

Lipid peroxidation and the levels of antioxidant enzymes in coronary artery disease

Coronary Artery Disease is the major cause of mortality and morbidity worldwide. Traditional risk factors account for only half of the morbidity and mortality from coronary artery disease. There is substantial evidence that oxidative stress plays the major role in the atherosclerotic process. The present study was undertaken to evaluate the level of lipid peroxidation (by measuring malondialdehyde) and antioxidant enzymes (ceruloplasmin, glutathione, superoxide dismutase) in coronary artery disease. Serum malondialdehyde levels and serum ceruloplasmin levels were significantly raised in all the subgroups of study group as compared to control group (p<0.001). Whole blood glutathione levels and hemolysate superoxide dismutase activity was significantly decreased in all the subgroups of study group as compared to control group (p<0.001). Above results suggests that the patients of coronary artery disease show increased oxidative stress and decreased levels of antioxidant enzymes. So it is recommended that the management protocol for coronary artery disease patients should include antioxidant supplementation along with simultaneous lowering of lipid peroxidation.     

Comparative account of serum lipids,lipoproteins and apolipoprotein-B in patients of coronary artery disease

Serum total lipids (cholesterol and triglyceride), lipoproteins (VLDL, LDL and HDL) and Apolipoprotein-B levels of normal healthy individuals (n=25) and coronary artery disease patients (n=25) were estimated. The objective of the present study was to ascertain the role of apo-B in causation and inheritance of coronary artery disease. It was observed that on an average serum total cholesterol and triglyceride more than 200 mg/dl bring the individuals to a risk of coronary artery disease (CAD) irrespective of the age. CAD patients achieved this value at an early age (35–45 years). Similarly VLDL and LDL levels were found to be significantly raised in CAD patients when compared to that of age matched normal individuals, with patients achieving risk values at an early age. HDL levels were found to be significantly lower in CAD patients as compared to normal individuals. Serum apo-B levels were significantly raised in CAD patients as compared to age matched normal individuals. Patients with positive family history of CAD had raised serum apo-B levels than those having negative family history. A positive coefficient of correlation was observed between serum apo-B and LDL levels suggesting that more the number of Apo-B particles, more will be the synthesis of atherogenic particle (LDL). Patients with negative family history had serum apo-B levels closer to those of normal individuals and in these individuals HDL levels were found to be significantly lowered, suggesting that loss of scavenger role of HDL could be the risk factor responsible for the causation of CAD in these patients, with negative family history of coronary artery disease.     

Lipoprotein (a) levels in alcohol drinking and alcohol non-drinking coronary artery disease patients

This study examines the role of alcohol drinking on lipoprotein(a) [Lp(a)] levels in angiographically assessed coronary artery disease patients. A lower Lp (a) level was noted in the alcohol drinking group as compared to the alcohol non-drinking group.     

The association of ABO blood groups with extent of coronary atherosclerosis in Croatian patients suffering from chronic coronary artery disease

Aim:

The aim of study was to: 1) examine the relationship between ABO blood groups and extent of coronary atherosclerosis in patients with chronic coronary artery disease (CAD), 2) compare ABO blood groups distribution in CAD patients and general population, 3) examine possible differences in traditional risk factors frequency in CAD patients with different ABO blood groups.

Materials and methods:

In the 646 chronic CAD patients (72.4% males) coronary angiograms were scored by quantitative assessment using multiple angiographic scoring system, Traditional risk factors were self reported or measured by standard methods. ABO blood distribution of patients was compared with group of 651 healthy blood donors (74.6% males).

Results:

Among all ABO blood group patients there was no significant difference between the extent of coronary atherosclerosis with regard to all the three scoring systems: number of affected coronary arteries (P = 0.857), Gensini score (P = 0.818), and number of segments narrowed > 50% (P = 0.781). There was no significant difference in ABO blood group distribution between CAD patients and healthy blood donors. Among CAD patients, men with blood group AB were significantly younger than their pairs with non-AB blood groups (P = 0.008). Among CAD patients with AB blood group, males < 50 yrs were significantly overrepresented when compared with the non-AB groups (P = 0.003).

Conclusions:

No association between ABO blood groups and the extent of coronary atherosclerosis in Croatian CAD patients is observed. Observation that AB blood group might possibly identify Croatian males at risk to develop the premature CAD has to be tested in larger cohort of patients.     

Oxidised LDL, HDL cholesterol, LDL cholesterol levels in patients of coronary artery disease

Coronary artery disease is a major cause of morbidity and has various risk factors. Lipid profile i.e. low HDL-cholesterol, high LDL cholesterol, high total cholesterol, high triglycerides playing important role in its causation. Recently interest has been shown in the oxidized fraction of LDL as one of the risk factors. In the present study 60 age and sex matched normal healthy individuals were taken as controls and 60 patients of CAD were taken. Cholesterol was measured by enzymatic method, HDL cholesterol by phosphotungstate precipitation method. Serum levels of LDL fraction of cholesterol was measured by a new and simpler method of precipitation. Result was expressed as mol/L of diene conjugates. It was observed that LDL cholesterol, VLDL cholesterol, total cholesterol, total cholesterol: HDL cholesterol, LDL cholesterol: HDL cholesterol were significantly raised and HDL cholesterol was significantly low in patients. (p<0.001). Though HDL cholesterol was significantly raised in females as compared to males in both the groups (p<0.001). Serum level of total cholesterol, oxidized LDL:HDL cholesterol were also raised significantly (p<0.05). The level of oxidized LDL showed an increasing trend in patients.     

Role of bilirubin, vitamin C and ceruloplasmin as antioxidants in coronary artery disease [CAD]

A study has been carried out on 250 CAD patients to see how the serum levels of three antioxidants i.e., Vitamin C, Bilirubin and Ceruloplasmin are related to the CAD risk factors and characteristics in these patients. The number of severe category CAD patients declined by 7–18% with increasing serum levels of the three antioxidants and, triple vessel disease declined by 14–20%. A decline of 39% in Myocardial Infarction (MI) occurred with increasing serum Ceruloplasmin. Serum Ceruloplasmin was significantly lower in the MI group compared to the non MI group CAD patients. There was a steady and a significant decline in the mean values of serum levels of cholesterol, Triglyceride, VLDL cholesterol along with BMI with increasing serum level. The study indicates that with increasing serum levels of the three antioxidants studied, the % MI along with % Triple vessel disease and severity of CAD goes down suggesting that the modifiable risk factors have to be suitably modified in order to maintain a reasonably high level of these antioxidants, as the risk factors are inversely related to the serum antioxidant levels.     

Raised serum homocysteine levels in patients of coronary artery disease and the effect of vitamin B12 and folate on its concentration

Homocysteine(Hcy) has been implicated as a novel risk factor of Coronary Artery Disease (CAD) among Asian Indians, but many studies done in India failed to reveal any direct correlation. It has also been reported that Folic acid and Vitamin B12 levels inversely affect serum levels of homocysteine. In this study, we looked at the levels of homocysteine among patients with CAD. The effect of Vitamin B12, Folate and other risk factors on homocysteine levels were also evaluated. Mean homocysteine levels in cases (22.81±13.9, n=70) were significantly higher (p=<0.001) than the controls (7.77±7.3, n=70). However no statistically significant correlation could be deduced between homocysteine Vitamin B12, and Folate. Cumulative analysis have indicated an increase in homocysteine levels among patients with CAD with every additional risk factor.     

Genes of renin angiotensin system and coronary heart disease

The levels of cytotoxic aldehydic products in different culinary oils, with or without thermal stress, (routine domestic or commercial frying) were determined by thiobarbituric acid method. The results showed that (i) thiobarbituric acid reactivity was much higher in edible oils rich in polyunsaturated fatty acids than those rich in saturated fatty acids or monounsaturated fatty acids, even without thermal stress, (ii) the lipid peroxide levels were in proportion to the duration of thermal stress, (iii) nature of the container used (steel, iron or teflon-coated) had no significant effect on the extent of lipid peroxidation under identical conditions of thermal stress and (iv) thermally stressed oils collected from hotels and roadside caterers contained higher levels of cytotoxic aldehydic products, when compared to oils thermally stressed under domestic frying conditions. These results suggest that dietary ingestion of thermally or autoxidatively stressed polyunsaturated fatty acid rich culinary oils is more harmful compared with those similarly treated oils rich in saturated fatty acids and monounsaturated fatty acids.     

The significance of troponin T and CK-MB release in coronary artery bypass surgery

Measurement of cardiac markers is an index of care standard in the assessment and diagnosis of cardiovascualr disease. Two of the major cardiac markers are Creatine Kinase isoenzyme CK-MB and Troponin T, which are extensively used in the diagnosis of heart disease. The release of Troponin T and creatine kinase isoenzyme (CK-MB) was investigated in 50 coronary artery bypass surgery patients. Measurement of plasma samples was carried out at five different time points, namely before surgery, 1,6,12,24 hours after surgery. The results indicated that CK-MB level were increased by a factor more than four times compared with the upper limit of baseline (befor surgery). Troponin T concentration showed more than six fold over the upper limit of baseline (before surgert) at 1,6,12,24 hours after surgery. In order to assess the significance of the length of the surgical procedure on the release of Troponin T and CK-MB, the surgery patient were divided into two groups according to the length of the surgical procedure: group I was selected on the basis that the surgical procedure they underwent lasted above 90 minutes and group II with a surgical procedure below 90 minutes. Both Troponin T and CK-MB showed a significant increase in-group I compared to group II. To investigate the likelihood that this effect is party due to myocardial infarction during surgery, the patients were divided into two groups: Group A with some sings of myocardial infarction on Q wave of ECG and group B without any change. The results showed approximately a two-fold increase of these markers in-group A compared to group B. Since these markers reach into blood following damage to myocardial their increase in patients with time course surgery of more than 90 minutes and those with a probability of MI during operation, indicating that these patient fall into a high risk group of repeat (MI) after surgery.     

新蝶呤——冠心病活动的一个新标志

目的　为了研究冠心病发病的可能机制 ,探讨可能诊治策略 .方法　对 4 0例冠脉造影证实的冠心病患者 (2 0例急性冠脉综合征 ,2 0例稳定心绞痛 )和 16例正常人测定了血清新蝶呤水平 ,并与临床分型进行了分析 .结果　发现冠心病患者新蝶呤水平显著高于正常人 (分别为(15 .16± 7.4 4) nmol/ L和 (8.38± 4 .6 9) nmol/ L,P<0 .0 1) .急性冠脉综合征患者新蝶呤水平显著高于稳定心绞痛患者 (分别为 (17.83± 8.38) nmol/ L和 (12 .5 0± 5 .34) nmol/ L,P<0 .0 5 ) ;而稳定心绞痛患者新蝶呤水平又显著高于正常人 (分别为 (12 .5 0± 5 .34) nmol/ L和 (8.38± 4 .6 9) nmol/L,P<0 .0 5 ) .结论　冠心病 ,特别是急性冠脉综合征患者新蝶呤水平显著升高 ,免疫激活可能参与了冠心病的病理生理过程 ,新蝶呤是冠心病活动的一个重要标志     

滋养细胞疾病的临床分析

目的本文对近10年中175例滋养细胞疾病住院患者的有关资料进行统计分析,以探讨该病的发病规律及流行病学特征,提高对该病的认识和防治水平。方法回顾调查分析了1994年1月～2004年1月,10年中收治的175例滋养细胞疾病。其中葡萄胎113例,侵蚀性葡萄胎20例,绒癌33例。结果40岁以上高龄孕妇中各类妊娠滋养细胞疾病的发病率均明显增高（P〈0．01）;妊娠滋养细胞疾病中,2次以上妊娠妇女发病明显升高,妊娠滋养细胞疾病发病率与孕次有明显的关联;占42％的A型血的患者发病相对危险度增加1．88倍,农村妊娠妇女发病相对危险度增加2．125倍;最主要临床表现为有停经史者147例,占84％,阴道流血史者163例,占93％。结论妊娠滋养细胞疾病在40岁以上的高龄孕妇发病比例明显高于其他年龄段;发病率与孕次有明显的关联,并以农村居民的发病率为高。     

Matrix metalloproteinase-3 (MMP-3) -1612 5A/6A promoter polymorphism in coronary artery disease in Indian population

Matrix metalloproteinases (MMPs) play important role in the pathogenesis of coronary artery disease (CAD). 5A allele of -1612 5A/6A polymorphism of MMP-3 is associated with two fold higher activity than 6A allele. Present study was designed to analyse the association of this polymorphism with CAD in Indian population. Subjects included in the study were patients with stable angina (n=35), unstable angina (n=53), patients with recent event of myocardial infarction (MI) (MI Group-1, n=56) and patients at presentation of the acute MI (MI Group-2, n=49). Controls were healthy individuals (n=99). Genotyping of MMP-3 5A/6A polymorphism was carried out by PCR-based restriction digestion method. The genotype distribution of patient groups did not deviate from controls. Serum MMP-3 levels were significantly elevated at presentation of the acute MI by 36.8% (P=0.031) as compared to controls and more associated with 6A genotype suggesting discrepancy between in vitro transfection experiment and peripheral MMP-3 levels.     

Association of serum ADMA,SDMA and L-NMMA concentrations with disease progression in COVID-19 patients

IntroductionThis study determines and compares the concentrations of arginine and methylated arginine products ((asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), n-monomethyl-1-arginine (L-NMMA) and homoarginine (HA)) for assessment of their association with disease severity in serum samples of COVID-19 patients.Materials and methodsSerum arginine and methylated arginine products of 57 mild-moderate and 29 severe (N = 86) COVID-19 patients and 21 controls were determined by tandem mass spectrometry. Moreover, the concentrations of some of the routine clinical laboratory parameters -neutrophil lymphocyte ratio (NLR), C-reactive protein, ferritin, D-dimer, and fibrinogen measured during COVID-19 follow-up were also taken into consideration and compared with the concentrations of arginine and methylated arginine products.ResultsSerum ADMA, SDMA and L-NMMA were found to be significantly higher in severe COVID-19 patients, than in both mild-moderate patients and the control group (P < 0.001 for each). In addition, multiple logistic regression analysis indicated L-NMMA (cut-off =120 nmol/L OR = 34, 95% confidence interval (CI) = 3.5-302.0, P= 0.002), CRP (cut-off = 32 mg/L, OR = 37, 95% CI = 4.8-287.0, P < 0.001), and NLR (cut-off = 7, OR = 22, 95% CI = 1.4-335.0, P = 0.020) as independent risk factors for identification of severe patients.ConclusionsThe concentration of methylated arginine metabolites are significantly altered in COVID-19 disease. The results of this study indicate a significant correlation between the severity of COVID-19 disease and concentrations of CRP, NLR and L-NMMA.     

网络社会本质与运行机制

文章探讨了网络社会的本质及运行机制，提出了关于网络社会的发展战略。     

Effect of caffeine on the risk of coronary heart disease— A re-evaluation

The effect of caffeine intake on the risk of coronary heart disease was studied. Twenty-one rats used were randomly divided into three experimental groups, the first group served as the control while the second and third groups were administered caffeine orally at doses of 10mg/kg body weight and 20mg/kg body weight respectively for fourteen days. Caffeine, at 10mg/kg body weight, significantly increased (P<0.05) serum LDL- cholesterol concentration and coronary heart disease risk ratio while it significantly reduced (P<0.05) serum triacylglycerol concentration when compared with controls. At 20mg/kg body weight, caffeine significantly increased (P<0.05) coronary heart disease risk ratio while it significantly reduced (P<0.05) serum HDL-cholesterol concentration and serum triacylgycerol concentration when compared with controls. No dose response effect was observed possibly suggestive of a threshold effect. These results suggest that caffeine predisposes consumers of caffeine containing beverages to coronary heart disease.     

浅析循环流化床锅炉的脱硫脱硝

本文介绍了循环流化床锅炉SO2、NOx产生过程及其特性,着重阐述循环流化床锅炉脱硫脱硝机理以及影响SO2、NOx排放浓度的各种因素,较合理的提出了降低循环流化床锅炉SO2、NOx排放浓度方法、措施等,对循环流化床的运行管理有一定的指导作用。     

Serum lipids during pregnancy in relation to the risk of coronary heart disease

The serum lipid classes in 75 pregnant women (25 in each trimester) and 25 matched controls were investigated. The lipid classes studied were very low density lipoproteins (VLDLc), low density lipoproteins (LDLc), high density lipoproteins (HDLc), total triacylglycerols (Tg), phospholipids (PL) and total cholesterol (Tc). It was found that there is increase in HDLc during first trimester followed by decrease during second and third trimesters. All other lipid classed including Tc and PL showed a progressive increase. Analysis of data showed that Tc/HDLc ratio has an increasing trend with parity. LDLc/HDLc also showed similar correlation. The results of our study indicates that there is likely to be increased risk for CHD in multiparous women as predicted from serum lipid parameters.     

LP(a) phenotypes and levels in angiographically proven coronary heart disease patients and controls

Lipoprotein Lp(a) excess has been identified as a powerful predictor of premature atherosclerotic vascular diseases. To evaluate this in a North-Indian population, 130 CAD patients and 130 controls were analyzed. The size of the apo(a) phenotypic isoforms was inversely proportional to Lp(a) concentrations. The mean concentration of Lp(a) in the CAD patients was 42±34 mg/dl whereas in the normal subjects it was much lower, 27±27 mg/dl. 157 subjects out of the total 260 subjects showed plasma levels of >20mg/dl. The frequency of high Lp(a) levels was much higher in patients(73%) than controls (43%). These data suggest (1) that there is heterogeneity of the Lp(a) polymorphism, (2) Higher Lp(a) levels were found in patients than in the controls, (3) Patients showed 1.5 fold increase in Lp(a) levels as compared to the controls. We conclude that low molecular weight apo(a) isoforms are significantly associated with increased risk of CAD in the North-Indian population.