Cost-effectiveness of Drug-Eluting Stents in Percutaneous Coronary Intervention in Brazil's Unified Public Health System (SUS)

The relationship between the carotid atherosclerosis ultrasound parameters and the cardiac and endothelial functions of coronary heart disease patients

PURPOSE

This study aimed to discover the relationship between the carotid atherosclerosis ultrasound parameters and the cardiac and endothelial functions of coronary heart disease patients.

METHODS

150 patients with coronary artery disease were divided into a single-branch group (one coronary artery with stenosis > 50%), a double-branch group (two coronary arteries with stenosis > 50%), and a multi-branch group (multiple coronary arteries with stenosis > 50%) based on the severity of each patient's coronary stenosis. Meanwhile, 50 healthy volunteers who were admitted to the hospital for routine health checks were recruited as the control group. This study tested the ultrasound parameters of carotid artery atherosclerosis among all the subjects in each group [common carotid artery sclerosis (β), carotid artery compliance (AC), elastic coefficient (Ep), pulse wave conduction velocity (PWVβ)], including the left ventricular end diastolic inner diameter (LVEDD), left ventricular ejection fraction (LVEF) and endothelial function parameters [endothelin-1 (ET-1), von Willebrand factor (vWF), and nitric oxide (NO)].

RESULTS

The study found that the β, AC, Ep, PWVβ, LVEDD, LVESD, ET-1, and vWF levels of patients with coronary artery disease were all higher than the corresponding levels in the control group (P < 0.05). The values increased as the number of coronary artery branches with stenosis increased (P < 0.05). The LVEF and NO of the patients with coronary artery disease were lower than they were in the control group (P < 0.05). The LVEF and NO decreased as the coronary artery branches with stenosis increased (P < 0.05). The correlation analysis indicated that the ultrasound parameter of carotid atherosclerosis has a significant positive relation with the LVEDD, LVESD, ET-1, and vWF levels (P < 0.05) and a negative relation with the LVEF and NO levels (P < 0.05).

CONCLUSION

The ultrasound parameter of carotid atherosclerosis, cardiac function, and endothelial function can be used for the early diagnosis of coronary heart disease.

The effect of nanoparticles of cobalt-chromium on human aortic endothelial cells in vitro

Despite advances in stent technology for vascular interventions, in-stent restenosis (ISR) remains a main complication. The corrosion of cobalt-chromium (CoCr) alloy coronary stents has been identified to be associated with ISR, whereas its role in ISR has not been elucidated. In the current work, CoCr nanoparticles, simulated corrosion products of CoCr alloy, were used to investigate their effect on the endothelial cells. It has been demonstrated that the cell viability declines and the cell membrane is damaged, indicating the cytotoxicity of CoCr nanoparticles. The expression of GRP78, CHOP, and cleaved-caspase12 proteins has increased when exposed to CoCr nanoparticles, suggesting that CoCr nanoparticles induced cell apoptosis through endoplasmic reticulum (ER) stress-mediated apoptotic pathway. An increased release of adhesion and inflammatory mediators was also induced by CoCr nanoparticles, including ICAM-1, VCAM-1, IL-1β, IL-6, and TNF-α. Our results demonstrated that CoCr nanoparticles could trigger apoptosis, adhesion, and inflammation. These findings indicated potential damaging effects of CoCr nanoparticles on the vascular endothelium, which suggested corrosion of CoCr alloy may promote the progression and development of ISR.