The study aimed to assess the association of high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) to major adverse cardiovascular events (MACE) in Takayasu arteritis (TA) patients with coronary artery disease (CAD). Data on 60 TA patients with CAD and 60 age- and severity-matched patients with CAD hospitalized in Fuwai Hospital from 2005 to August 2014 were assessed. The clinical features, laboratory data, coronary angiographic findings, treatment, and follow-up outcomes were summarized retrospectively. MACE were defined as death from cardiac causes, myocardial infarction, nonfatal target vessel revascularization, or rehospitalization due to unstable or progressive angina. CAD patients had more atherogenic lipid and lipoprotein profiles such as lower levels of high-density lipoprotein cholesterol (HDL-C) (1.0 ± 0.2 vs. 1.3 ± 0.3 mmol/L, p = 0.01) and higher levels of low-density lipoprotein cholesterol (LDL-C) (2.5 ± 0.9 vs. 2.2 ± 1.1 mmol/L, p = 0.04) in contrast with TA-CAD patients. During a mean follow-up period of 3.2 years, 31 patients with Takayasu coronary arteritis reached the endpoint. Multivariate Cox proportional hazards model demonstrated that log(hsCRP) (HR = 5.3, 95 % CI = 1.1-27.8, p = 0.04) was a significant and independent predictor of MACE in patients with Takayasu coronary arteritis. Elevated baseline levels of hsCRP predict cardiovascular events, independent of other prognostic markers in TA-related CAD patients.

Our study aimed to determine whether proatherogenic lipid profiles exist in patients with active Takayasu arteritis (TA) and assess the relationship between different lipid profiles and disease activity in TA. A total of 132 premenopausal female patients with TA and 100 sex-, age-, and body mass index-matched healthy controls were included in our study. The clinical data were collected in detail from all participants. Patients with active TA had significantly lower levels of apolipoprotein A1 (apoA1) (1.47 ± 0.30 vs. 1.99 ± 0.33 mmol/L, p < 0.001) and lower levels of high-density lipoprotein cholesterol (HDL-C) (1.23 ± 0.33 vs. 1.68 ± 0.38 mmol/L, p < 0.001) than patients with inactive TA. However, they had higher ratios of apolipoprotein B (apoB)/apoA1 (0.74 ± 0.27 vs. 0.48 ± 0.14, p < 0.001) compared with patients with inactive TA. Multiple linear regression analysis demonstrated that the apoB/apoA1 ratio was independently associated with TA activity (β = 0.38, p = 0.04). In addition, multivariate stepwise forward regression analysis showed that the apoB/apoA1 ratio was the major determinant for high-sensitivity C-reactive protein (β = 0.58, p = 0.002). Our findings indicate that patients with active TA had proatherogenic lipid profiles. In addition, the ratio of apoB to apoA1 could be used as a marker for monitoring and targeting patients with TA.

trial studies combination transarterial chemoembolization (TACE) and Stereotactic Body Radiation Therapy (SBRT) for BCLC A patients with HCC from 4-7 cm. Materials/Methods: Patients were eligible if they were BCLC A, Child-Pugh score 7, had a single HCC from 4-7 cm, no evidence of macrovascular invasion, no evidence of metastatic disease, ECOG 0, and were not suitable for resection or liver transplantation. Treatment consisted of drug-eluting bead (DEB)-TACE at time 0 and 1 month followed by SBRT completed within 2-3 weeks following TACE. Each DEB-TACE treatment utilized 1 vial of 100-300 micron LC Beads (BTG) loaded with 50mg of doxorubicin. SBRT was delivered from 35-50 Gy in 5 fractions. The primary end-point of the study was best objective response by mRECIST (measured 1 month post-treatment and every 3 months thereafter). Secondary endpoints were progression free survival (PFS), cancer specific survival (CSS), overall survival (OS) assessed using the Kaplan-Meier method. Results: From 2014-2018, 25 patients were enrolled in a single institution with a median follow of 18 months (range 1-47). Baseline patient characteristics are shown in Table 1. Every patient completed the protocol as planned except one who only received DEB-TACEx1 before SBRT. 24 patients had at least one post treatment scan to assess mRECIST response (one patient lost to follow up). Best objective response in the target lesion was 92%: 64% complete response (nZ16), 28% partial response (nZ7), 0%stable disease, and 4% progression of disease (nZ1). Median time to CR was 3 months (range 1-17). 1-and 2-year OS was 80% and 67%, respectively. 1-and 2-year PFS was 67% and 52%, respectively. CSS was 91% at 1 year and 83% at 2 years. Conclusion: Preliminary results from this Phase II trial show very promising response rates when combining TACE+SBRT in large, unresectable HCC with excellent OS, PFS, and CSS. These preliminary data are currently being confirmed in an expanded cohort.

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