简介:BackgroundComparedtoclopidogrel,Ticagrelorsignificantlyreducestheriskofcardiovasculareventsinpatientswithacutemyocardialinfarction(AMI)howeverincreasestheincidenceofbleedingandtheriskoffatalintracranialhemorrhage.Inthisstudy,wescreenedtheAMIpatientswithclopidogrelresistence,anddeterminedwhetherticagrelorsequentialtherapycouldreducetheriskofcardiovasculareventsandbleedingrisk.MethodsAtotalof319AMIpatientswereenrolledinthisprospectiveclinicalstudy.Theplateletinhibitionratesinadenosine5'-diphosphate(ADP)pathwaysweremeasuredbyathrombelastography(TEG)system.ThepatientswithclopidogrelresistanceweredividedintoTicagrelorsequentialtherapygroup(ticagrelorfor3monthsandclopidogrelfor9months,n=143)andClopidogrelgroup(clopidogrelfor12months,n=176).Theriskofmajoradversecardiacevents(MACE)andthesafetyendpointsat1-yearfollow-upwereanalyzed.ResultsTheratesofstentthrombosis(ST)(2.1%vs.8.0%,P=0.017)orMI(2.8%vs.10.2%,P=0.009)werelowerintheticagrelorsequentialtherapygroupthanintheclopidogrelgroup.Dyspneawasmoreoftenintheticagrelorsequentialtherapygroupthanintheclopidogrelgroup(17.5%vs.4.5%,P<0.001).Nosignificantdifferenceintherateofmajorbleedingwasfoundbetweenthegroups(3.4%vs.3.9%,P=0.528).ConclusionsInAMIpatientswithhyporesponsivenesstoclobidogrelticagrelorsequentialtherapygroupsignificantlydecreasedtheratesofSTandMIwithoutincreasedriskofmajorbleedingascomparedwithclopidolgrel.
简介:ObjectivesToexploretheprotectiveeffectofirbesartan(Irb)undertheinterferencewithangiotensinⅡ(AngⅡ)onABCA1.MethodsElectronmicroscopywasusedtodetectthemorphousoffoamcells.TheexpressionofABCA1mRNAanditsproteinweredeterminedbyRT-PCRandWesternblotting,respectively.Thevarianceofcellularcholesterolcontentwasmeasuredbyzymochemistryvia-fluorospectrophotometer.ResultsApositivefacilitativeeffectofAngⅡontheformationoffoamcellswasobserved.TotalcholesterolwasincreasedsignificantlybyAngⅡ,theexpressionofABCA1wasdown-regulatedobviouslybyAngⅡ;IrbcouldprotectABCA1againstthelesionofAngⅡ;TotalcellularcholesterolcontentwasreducedsignificantlyinIrb+AngⅡgroup;However,considerablealterationaboutthecholesterolcontentandtheexpressionofABCA1werenotobservedinIrbgroupwithoutincubationwithAngⅡ.ConclusionsIrbcouldprotectABCA1againstthelesionofAngⅡ,whichmaycontributetoitsanti-atheroscleroticproperties.
简介:ObjectivesToinvestigatetheeffectofGαq/11signalingpathwayandATP-sensitivepotassiumchannel(KATPchannel)onischemicpreconditioning(IPC)protectioninrathearts.MethodsTwoseriesofexperimentswereperformedinWistarrathearts.Inthefirstseriesofexperiment,ischemicpreconditioningwasinducedbyleftanteriordescendingocclusion(three,5minepisodesseparatedby5minofreperfusion),ischemia-reperfusioninjurywasinducedby30mincoronaryarteryocclusionfollowedby90minreperfusion.Hemodynamics,infarctsizeandscoresofventriculararrhythmiasweremeasured.TheexpressionofGαq/11proteinintheheartwasmeasuredbyWesternblotanalysisinthesecondseries.ResultsIschemicpreconditioningratsshoweddecreasedinfarctsizeandscoresofventriculararrhythmiavsnon-IPcontrolrats.TheeffectofIPCwassignificantlyattenuatedbyglibenclamide(1mg/kg,ip),anonselectiveKATPchannelinhibitor.IPCcausedasignificantincreaseintheexpressionofGαq/11protein.ConclusionsActivationsofGαq/11signalpathwayandKATPchannelplayedsignificantrolesintheclassicalcardioprotectionofischemicprecon-ditioningratheartandmightbeanimportantmechanismofsignaltransductionpathwayduringtheischemicpreconditioning.
简介:目的观察不同剂量的ATP终止不同年龄组阵发性室上性心动过速(PSVT)时复律时间、长间歇及其副作用。方法以静脉给药,将56例随机分为青年组(A组)、中年组(B组)和老年组(C组)。结果56例PS—VT全部中止.各组复律时间无差异。结论C组长间歇延长、副作用和剂量有关,C组用量宜从最低剂量开始。