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Diez Villanueva P, Garcia-Guimaraes M, Vera A, Moreu J, Ojeda S, Nogales J, Salamanca J, Veiga G, Masotti M, Camacho-Freire S, Jimenez-Valero S, Jimenez-Kockar M, Lozano I, Bastante T, Alfonso F. Spontaneous coronary artery dissection in the elderly: clinical features, angiographic findings, management and outcomes. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS). Clinical features, angiographic findings, management and outcomes of SCAD in elderly patients remain unknown.
Methods
The Spanish multicenter prospective SCAD registry included 318 consecutive patients with SCAD diagnosis. Patients were classified according to age in two groups: <65 and ≥65 years old.
Results
A total of 55 patients (17%) were 65 or older (Table). Elderly patients had more often hypertension (29% vs 76%, p<0.01) and dyslipidemia (30% vs 56%, p<0.01), and less smoking history (51% vs 7%, p<0.01). Previous history of coronary artery disease was also more frequent in older patients (4% vs 11%, p=0.044). Interestingly, an identifiable trigger was more often found among patients under 65. Coronary artery tortuosity (1±0.99 vs 1.4±1, p=0.027) and coronary artery ectasia (9% vs 24%, p<0.01) were both more frequent in elderly patients, who were more often managed conservatively (75% vs 89%, p=0.025). A trend toward a higher mortality rate was found among patients ≥65, with no differences in terms of in hospital stay, new acute myocardial infarction, unplanned coronariography or heart failure.
Conclusions
Elderly patients with SCAD show different clinical and angiographic characteristics and they receive distinct management. Short-term outcomes do not significantly differ from those seen in younger patients.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | - A Vera
- Hospital Universitario La Princesa, Madrid, Spain
| | - J Moreu
- Hospital Virgen de la Salud, Cardiology, Toledo, Spain
| | - S Ojeda
- University Hospital Reina Sofia, Cardiology, Cordoba, Spain
| | - J.M Nogales
- Hospital Infanta Cristina de Badajoz, Cardiology, Badajoz, Spain
| | - J Salamanca
- University Hospital De La Princesa, Cardiology, Madrid, Spain
| | - G Veiga
- University Hospital Marques de Valdecilla, Cardiology, Santander, Spain
| | - M Masotti
- Barcelona Hospital Clinic, Cardiology, Barcelona, Spain
| | | | | | - M Jimenez-Kockar
- Hospital de la Santa Creu i Sant Pau, Cardiology, Barcelona, Spain
| | - I Lozano
- Hospital de Cabuenes, Cardiology, Gijon, Spain
| | - T Bastante
- University Hospital De La Princesa, Cardiology, Madrid, Spain
| | - F Alfonso
- University Hospital De La Princesa, Cardiology, Madrid, Spain
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Durante-Rodríguez G, Gómez-Álvarez H, Blázquez B, Fernández-Llamosas H, Martín-Moldes Z, Sanz D, Nogales J, Carmona M, Díaz E. Chapter 13. Anaerobic Pathways for the Catabolism of Aromatic Compounds. Energy and Environment Series 2018. [DOI: 10.1039/9781788010351-00333] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Nogales J, Guijo MI, Quesada A, Merchán F. Functional analysis and regulation of the malate synthase from Chlamydomonas reinhardtii. Planta 2004; 219:325-331. [PMID: 14991408 DOI: 10.1007/s00425-004-1223-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2003] [Accepted: 12/29/2003] [Indexed: 05/24/2023]
Abstract
Malate synthase (EC 2.3.3.9, formerly EC 4.1.2.2) has been investigated in the unicellular green algae Chlamydomonas reinhardtii. The molecular characteristics and the regulation of gene expression have been investigated for the enzyme. A full-length malate synthase cDNA has been isolated, containing an open reading frame of 1,641 bp encoding a polypeptide of 546 amino acids. This protein shares the conserved signature of the malate synthase family, along with the catalytic residues essential for enzymatic activity and a C-terminal motif that matches the consensus for glyoxysome import. Functionality studies have been facilitated by heterologous expression of the malate synthase cDNA in Escherichia coli. The remarkable metabolic versatility of the alga has been used to analyse the metabolic control of malate synthase gene expression. The data strongly support the role of acetate and light as the main regulatory effectors, and the existence of cross-talk between the two signalling pathways.
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Affiliation(s)
- J Nogales
- Department of Molecular Microbiology, Centro de Investigaciones Biológicas-CSIC, C/ Ramiro de Maeztu n masculine 9, 28040 Madrid, Spain
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Abstract
One hundred and five 5-week-old male rats were used to study the influence of the stability of an osteotomy on longitudinal overgrowth of the bone. In 45 rats (Group 1) a transverse diaphyseal osteotomy of the right tibia was made; the left tibia was left untreated. In the second 45 rats (Group 2) the right tibia was osteotomized after applying an external fixator; the left tibia underwent a sham operation without osteotomy. Fifteen further rats (Group 3) were used as a nonoperated control group. After being measured at different periods up to 20 weeks, the osteotomized tibiae of the Group 1 (unstable) were 16-25% longer than those of their nontreated limbs (P < 0.001). The osteotomized tibiae of the Group 2 (stable) were 6-11% longer than those of the sham-operated opposite limbs (P < 0.001). The osteotomized and unstable tibiae were 9-17% longer than the osteotomized and stable tibiae (P < 0. 001) throughout the whole study. Although several factors have been considered to be responsible for longitudinal bone overgrowth after fracture in young animals, this work suggests that bone's stability plays a decisive role in the final outcome.
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Affiliation(s)
- G L Garcés
- Instituto Canario de Ortopedia Traumatología, University of Las Palmas de Gran Canaria, Las Palmas Spain
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