BackgroundPeripartum cardiomyopathy (PPCM) is a potentially life-threatening complication of pregnancy. The identification of early prognostic markers in patients diagnosed with PPCM is very important. The systemic immune-inflammation index (SII) is a new inflammatory biomarker, and the aim of this study was to evaluate the prognostic value of SII in patients with PPCM.MethodsA total of 61 patients with PPCM who were admitted in our hospital from 2015 to 2020 were retrospectively analyzed in this study. The follow-up period of all patients was at least 6 months after diagnosis. Recovery of left ventricular (LV) systolic function was defined as the presence of left ventricular ejection fraction > 45%. The second endpoint was defined as composite adverse cardiac events, including cardiac death or hospitalization due to worsening heart failure. Univariate and multivariate logistic regression analysis were used to determine the independent predictors of non-recovery of LV systolic function. The receiver operating characteristic (ROC) curve analysis was used to establish a cut-off level of SII value to predict persistent LV systolic dysfunction.ResultsThe follow-up duration was 40.5 ± 16.3 months. Among the 61 patients, 43 patients showed left ventricular recovery and 18 patients did not at the last follow-up visit. The baseline SII levels were significantly higher in the non-recovery group (P < 0.05). Multivariate logistic regression showed that the SII and left ventricular end-diastolic dimension (LVEDD) were independent predictors of persistent LV systolic dysfunction (OR: 1.177, 95% CI: 1.038–1.335, P = 0.011 and OR: 1.148, 95% CI: 1.011–1.304, P = 0.033, respectively). A SII value of 876 was the best cut-off value (the area under the curve was 0.791, 95% CI: 0.667–0.915, P < 0.05), and the sensitivity and specificity were 73 and 71%, respectively.ConclusionsThe SII and LVEDD are independent prognostic factors for persistent LV systolic dysfunction in patients with PPCM. The SII may be a useful tool for identifying high-risk PPCM patients.

Background: Takayasu arteritis is a rare chronic granulomatous inflammation involving the aorta and its main branches. In this report, we describe an extremely rare elderly male patient with Takayasu arteritis (TA) after coronary artery bypass grafting (CABG).Case Summary: A 61-year-old male patient with persistent precordial pain underwent angiography. Vascular murmurs could be heard in carotid artery and bilateral renal artery by auscultation. Laboratory parameters showed high Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP). CT coronary angiography showed multiple stenoses of aorta and its main branches, such as carotid and renal artery involvement. Coronary angiography showed that the coronary artery had multiple branch stenoses, the left anterior descending artery (LAD) had severe stenosis, the distal end of which was reversed to the right coronary artery (RCA), and the RCA was completely occluded. Because of the high level of markers of inflammatory activity, the patient began to take glucocorticoid. Although the patient still had multibranch stenosis of coronary artery, considering the previous CABG operation history, surgery, and interventional therapy of the patient were not feasible, the patient was given conservative drug for further treatment. After treatment, the inflammatory index was significantly descended, and N terminal-pro Brain natriuretic peptide (NT-pro BNP) was decreased.Discussion: A rare case of an elderly male patient with Takayasu arteritis after coronary artery bypass grafting was reported. In addition to hypertension, hyperlipidemia, and other risk factors, coronary artery involvement caused by TA may be a major cause of aggravation of symptoms in patients with acute myocardial infarction (AMI), especially after CABG.

Background Traditional Chinese medicine (TCM) Tongxinluo (TXL) capsules have been widely used in atherosclerosis treatment. Previous studies have demonstrated the TXL can retard the progression of atherosclerosis and reduce the incidence of cardiovascular events. In the present study (TXL-CAP trial), we aim to evaluate the efficacy of TXL on non-ST elevation acute coronary syndrome (NSTE-ACS) treatment. Methods This study is a randomized, double-blind, placebo-controlled, parallel-grouped multicenter clinical study and 220 patients diagnosed with NSTE-ACS will be enrolled. Patients will be randomized 1:1 to receive the TXL or placebo in addition to their standard treatment. The primary end point is the difference in the thickness of the fibrous cap of the target coronary artery plaque evaluated by OCT. The secondary observation indicators included the incidence of major adverse cardiovascular events (MACE), the proportion of patients with improved angina pectoris, Seattle angina pectoris questionnaire score, and serum levels of inflammatory cytokines (IL-1 β, IL-18, TNF- α). Conclusion The results of the TXL-CAP trial will provide clinical data for revealing whether TXL capsules stabilize vulnerable plaques in Chinese NSTE-ACS patients. Trial registration: The trial was registered at the Chinese Clinical Trial Registry on September 10, 2019 (http://www.chictr.org.cn). The registration Number was ChiCTR1900025842.