Major adverse cardiovascular events in bulgarian patients with chronic coronary syndrome

Background

In primary prevention, most guidelines rely on atherosclerotic cardiovascular disease risk assessment to determine the appropriateness and intensity of risk factor modification.

Aims

This study aimed to analyze the prognostic role of risk factors, comorbidities, and coronary artery calcium score (CACS) for major adverse cardiovascular events (MACEs) in Bulgarian patients with chronic coronary syndrome. An observational study conducted in a cardiology department. This observational study included 214 patients. The study population was divided into three major groups according to their CACS level estimated with the Agatston calculating model: 0 (group I), 1-400 (group II), and >400 (group III) Agatston units (AU). The patients were followed-up for MACE development over a mean period of 3.8 years.

Subjects and Methods

The Cox proportional hazard regression analysis was performed.

Results

The MACE rate in patients with CACS = 0 was significantly higher in patients with low-density lipoprotein >3 mmol/L (hazard ratio [HR] 3.5; 95% confidence interval [CI] 1.87-6.64; P < 0.05) and with paroxysmal atrial fibrillation (HR 4.33; 95% CI 1.25-16.92; P < 0.05). In group II, the incidence of MACE was significantly elevated in patients with coronary calcium volume >75 Hounsfield units (HU) (HR 3.56; 95% CI 1.39-9.14; P < 0.05), calcium score of aortic valve >30 AU (HR 3.2; 95% CI 1.36-4.76; P < 0.05), and left ventricular mass over 125 g (HR 3.24; 95% CI 1.65-7.56; P < 0.05).

Conclusions

Our data revealed that different factors in the risk profile of the three patient groups were associated with an increased rate of MACEs.

A novel approach for fabricating nanocomposite materials by embedding stabilized core-shell micelles into polysaccharide cryogel matrix

We report a novel approach for fabricating nanocomposite polysaccharide-based carriers for sustained delivery of poorly-water-soluble drugs by embedding stabilized core-shell micelles (SPM) possessing hydrophobic cores into super-macroporous hydroxypropyl cellulose (HPC) cryogels. Firstly, nano-sized SPM were synthesized by loading and photochemical crosslinking of pentaerythritoltetraacrylate (PETA) in poly(ethylene oxide)-b-poly(propylene oxide)-b-poly(ethylene oxide) (PEO₁₉PPO₂₉PEO₁₉) core-shell micelles. Next, HPC cryogels containing different amount of SPM were fabricated by combination of cryogenic treatment and photo-crosslinking. A crosslinking agent, N,N'-methylenebisacrylamide, was used to enhance the density of polymer network. The effect of SPM concentration on gel fraction yield, swelling degree, cryogel morphology and mechanical properties were studied. Nanocomposite cryogels were loaded with curcumin and their encapsulation efficiency and drug release profile as a function of SPM content were investigated. The cytotoxic effect of blank and curcumin loaded nanocomposite cryogels was assessed as well.