ObjectiveCurrently radiofrequency and cryoballoon ablations are the two standard ablation systems used for catheter ablation of atrial fibrillation; however, there is no universal consensus on which ablation is the optimal choice. We therefore sought to undertake a meta-analysis with special emphases on comparing the efficacy and safety between cryoballoon and radiofrequency ablations by synthesizing published clinical trials.Methods and ResultsArticles were identified by searching the MEDLINE and EMBASE databases before September 2013, by reviewing the bibliographies of eligible reports, and by consulting with experts in this field. Data were extracted independently and in duplicate. There were respectively 469 and 635 patients referred for cryoballoon and radiofrequency ablations from 14 qualified clinical trials. Overall analyses indicated that cryoballoon ablation significantly reduced fluoroscopic time and total procedure time by a weighted mean of 14.13 (95% confidence interval [95% CI]: 2.82 to 25.45; P = 0.014) minutes and 29.65 (95% CI: 8.54 to 50.77; P = 0.006) minutes compared with radiofrequency ablation, respectively, whereas ablation time in cryoballoon ablation was nonsignificantly elongated by a weighted mean of 11.66 (95% CI: −10.71 to 34.04; P = 0.307) minutes. Patients referred for cryoballoon ablation had a high yet nonsignificant success rate of catheter ablation compared with cryoballoon ablation (odds ratio; 95% CI; P: 1.34; 0.53 to 3.36; 0.538), and cryoballoon ablation was also found to be associated with the relatively low risk of having recurrent atrial fibrillation (0.75; 0.3 to 1.88; 0.538) and major complications (0.46; 0.11 to 1.83; 0.269). There was strong evidence of heterogeneity and low probability of publication bias.ConclusionOur findings demonstrate greater improvement in fluoroscopic time and total procedure duration for atrial fibrillation patients referred for cryoballoon ablation than those for radiofrequency ablation.

Metformin can prevent transient endothelial dysfunction caused by acute glucose load in patients with PH.

We assessed the association between 5 well-defined polymorphisms of the transforming growth factor-β1 (TGFB1) gene and coronary artery disease (CAD) among patients with hypertension from northeast China. All study participants were classified into patients with CAD (n = 679) and controls (n = 686) according to angiographic results. Genotyping was carried out with the ligase detection reaction method. In single-locus analysis, only genotypes of rs1800469 differed significantly between patients with CAD and controls (P = .001); patients carrying the mutant allele of rs1800469 exhibited a 73% increased risk of CAD (P < .001). Haplotype analysis indicated that haplotype A-T-T-C-C (alleles in the order of rs1800468, rs1800469, rs1800470, rs1800471, and rs1800472) was associated with a 1.49-fold increased risk (P = .003). Interaction analysis identified an overall best 3-locus model including rs1800469, rs1800468, and rs1800471 (P = .003). Taken together, we identified a synergistic interaction between TGFB1 gene multiple polymorphisms that entailed greater risk of CAD in Chinese patients.

ABSTRACT. This study aimed to investigate the influence of acute glycemic load on vascular endothelial function in patients with hypertension and to evaluate the protective effect of vitamins C and E during the acute glycemic phase. We randomly selected 39 hypertensive patients and 21 normal subjects and divided them into 3 groups: 75 g oral glucose (glycemic load group), 75 g glucose + 0.9 g vitamin C (VC group), 75 g glucose + 2 g vitamin C + 0.8 g vitamin E (VC + VE group). Extravascular color Doppler ultrasound was used to detect brachial artery flow-mediated vasodilation at 0, 1, 2, and 3 h, and, at the same time, serum anti-oxidant products were measured. Basic endothelial functions in patients with hypertension were decreased in the glycemic load group (9.48 ± 3.33 versus 13.09 ± 6.78%, P < 0.05), and was even more depressed in the hypertensive group (9.48 ± 3.33 versus 14.20 ± 6.48%, P < 0.05). Antioxidant vitamins played a dose- 7247©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 13 (3): 7246-7255 (2014) Protective effects of vitamin C and E in hypertension dependent protective role on acute damage of endothelial function due to glycemic load. Acute high blood sugar damaged vascular endothelial functions, especially in hypertensive patients, but this effect can be reversed by large doses of vitamin C and E.