Patients with diabetes mellitus are at increased risk for repeat interventions and mortality after coronary angioplasty and stenting. The efficacy of sirolimus-eluting stents (SESs) to improve the outcomes of these patients is a focus of interest. In the first 1,407 patients treated with SESs at our institution, 492 were diabetic (insulin dependent diabetes mellitus [IDDM], n = 160 and non-insulin-dependent DM [NIDDM], n = 332). The in-hospital and 1- and 6-month clinical outcomes were compared with those of 915 patients without DM (non-DM). The baseline characteristics were similar, except for more women, obesity, previous myocardial infarction, coronary artery bypass grafting, and renal insufficiency in the DM group (p <0.001). Compared with non-DM patients, DM patients had higher in-hospital (p <0.05) and 1-month mortality (p = 0.02). IDDM patients had more in-hospital renal failure (p = 0.04) and Q-wave myocardial infarctions (1.6% vs 0%, p = 0.04) compared with NIDDM patients, and higher mortality (3.1% vs 0.8%, p = 0.04) and subacute stent thromboses (2.3% vs 0.5%, p = 0.07) than non-DM patients at 30 days. At 6 months, DM patients had a higher incidence of Q-wave myocardial infarction, target lesion revascularization-major adverse cardiac events, and composite of death and Q-wave myocardial infarction than non-DM patients (6.0% vs 2.7%, p = 0.01). Late outcomes between the IDDM and NIDDM groups were similar. Multivariate analysis showed diabetes and acute renal failure as independent predictors of target lesion revascularization-major adverse cardiac events. In conclusion, our data showed that, despite a reduction in repeat revascularization, coronary intervention with SESs in diabetic patients is limited by higher mortality at 1 month and a higher incidence of Q-wave myocardial infarction and target lesion revascularization-major adverse cardiac events at 6 months compared with non-DM patients. Careful surveillance is required in IDDM patients undergoing SES implantation.
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http://dx.doi.org/10.1016/j.amjcard.2005.06.031 | DOI Listing |
Cardiol Ther
January 2025
Adult Medicine, Department of Clinical Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
Introduction: This prospective, single-arm pharmacodynamic study assessed the effect of colchicine (COLC) [Strides Pharma UK Ltd, Watford, Hertfordshire, England] 0.5 mg administered orally once daily for 14 days on platelet reactivity with respect to aspirin reaction units (ARUs) and P2Y reaction units (PRUs).
Methods: Twenty-two patients with stable coronary artery disease (CAD) on dual antiplatelet therapy (DAPT) with daily maintenance aspirin and clopidogrel were recruited.
Pediatr Cardiol
January 2025
Department of Infectious Disease, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, No. 1678 Dongfang Road, Pudong New Area, Shanghai, 200127, China.
Kawasaki disease (KD) is a febrile vasculitis disorder, with coronary artery lesions (CALs) being the most severe complication. Early detection of CALs is challenging due to limitations in echocardiographic equipment (UCG). This study aimed to develop and validate an artificial intelligence algorithm to distinguish CALs in KD patients and support diagnostic decision-making at admission.
View Article and Find Full Text PDFJ Biophotonics
January 2025
Department of Electrical Engineering, Columbia University, New York, New York, USA.
Epicardial catheter ablation is necessary to address ventricular tachycardia targets located far from the endocardium, but epicardial adipose tissue and coronary blood vessels can complicate ablation. We demonstrate that catheter-based near-infrared spectroscopy (NIRS) can identify these obstacles to guide ablation. Eighteen human ventricles were mapped ex vivo using NIRS catheters with optical source-detector separations (SDSs) of 0.
View Article and Find Full Text PDFZhongguo Dang Dai Er Ke Za Zhi
January 2025
Department of Pediatrics, Third People's Hospital of Longgang District of Shenzhen, Shenzhen, Guangdong 518020, China.
Objectives: To explore the role of berberine (BBR) in ameliorating coronary endothelial cell injury in Kawasaki disease (KD) by regulating the complement and coagulation cascade.
Methods: Human coronary artery endothelial cells (HCAEC) were divided into a healthy control group, a KD group, and a BBR treatment group (=3 for each group). The healthy control group and KD group were supplemented with 15% serum from healthy children and KD patients, respectively, while the BBR treatment group received 15% serum from KD patients followed by the addition of 20 mmol/L BBR.
J Cardiothorac Surg
January 2025
Dongying People's Hospital (Dongying Hospital of Shandong Provincial Hospital Group), Dongying, 257091, Shandong, People's Republic of China.
Background: Atherosclerosis (AS) is increasingly recognized as a chronic inflammatory disease that significantly compromises vascular health and acts as a major contributor to cardiovascular diseases. Advancements in lipidomics and metabolomics have unveiled the complex role of fatty acid metabolism (FAM) in both healthy and pathological states. However, the specific roles of fatty acid metabolism-related genes (FAMGs) in shaping therapeutic approaches, especially in AS, remain largely unexplored and are a subject of ongoing research.
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