Angiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non-left main bifurcation lesions once the procedure was performed successfully.
Fixed-dose combinations of ezetimibe/rosuvastatin significantly improved lipid profiles in patients with hypercholesterolemia compared with rosuvastatin monotherapy. All groups treated with rosuvastatin and ezetimibe reported a decrease in mean LDL-C level >50%. The safety and tolerability of ezetimibe/rosuvastatin therapy were comparable with those of rosuvastatin monotherapy. ClinicalTrials.gov identifier: NCT02749994.
BackgroundResistin is an adipocyte-secreted hormone. The relationship between circulating resistin concentrations and atherosclerotic coronary artery disease (CAD) in type 2 diabetic patients, if any, remains poorly understood. Serum resistin concentrations were investigated in type 2 diabetic patients with CAD (DMCAD), and compared with the concentrations in diabetics patients without CAD (diabetes mellitus, DM). Whether resistin levels are associated with increased restenosis rates in diabetic patients with CAD after successful coronary stenting was also investigated. Methods and Results Fasting serum resistin, adiponectin, and leptin concentrations were measured in 45 DMCAD patients and 47 DM controls. The percutaneous coronary intervention study included 70 DMCAD patients, who underwent elective and successful coronary bare metal stent (BMS) implantation for the treatment of de novo lesions. Serum resistin concentrations were higher in the DMCAD patients than in the DM controls (5.75±3.21 vs 2.53±2.47 ng/ml, mean ± SEM, p<0.001), and these differences were persistent regardless of age or body mass index. Insulin resistance indices, as assessed via homeostasis model assessment (HOMA-IR) correlated significantly with resistin concentrations (r=0.4, p<0.001). Resistin was an independent factor, and was associated with DMCAD in the multivariate analysis. In the percutaneous coronary intervention study, HOMA-IR was not associated with subsequent restenosis rates after BMS implantation in DMCAD patients. Pre-procedural serum resistin concentrations were higher in restenosis group than in the patients without restenosis. Conclusions Serum resistin may prove to be a useful biological marker for CAD and restenosis in patients with type 2 DM. (Circ J 2007; 71: 868 -873)
IntroductionInappropriate antiplatelet therapy discontinuation increases the risk of thrombotic complications and bleeding after dental procedures. To determine the platelet reactivity recovery time after aspirin withdrawal in vivo, our study was conducted in patients with low-risk cardiovascular disease who can stop aspirin administration following the guidelines stipulated by the American College of Chest Physicians. The time it takes for platelet activity to normalize and the diagnostic accuracy of testing methods were assessed for a residual antiplatelet activity with multiple electrode aggregometry. Our study included patients with clinically indicated hypertension preparing for a dental extraction procedure.Materials and methodsA total of 212 patients not taking aspirin (control group) and 248 patients with hypertension receiving long-time aspirin treatment at a 100-mg daily dose were prospectively included in the study, which involved stopping aspirin intake before dental extraction. The residual platelet activity and dental bleeding in patients who stopped aspirin intake were analyzed and compared with those of the control group. In addition, platelet reactivity recovery time and bleeding risk in patients who stopped taking aspirin every 24 hours for 0 to 5 days (0–143 hours) before dental extraction was also assessed.ResultsPlatelet reactivity normalized 96 hours after aspirin withdrawal. The cut-off value of 49 arbitrary units in the arachidonic acid platelet aggregation test excluded the effect of aspirin with 91% sensitivity and 66% specificity. AUC showed 0.86 (P < 0.001) diagnostic accuracy. The immediate bleeding complications in all treatment groups were similar to those seen in the control group and were successfully managed with local hemostatic measures.ConclusionsThe antiplatelet effects of aspirin disappeared 96 hours after aspirin withdrawal in our study, and dental extractions may be safely performed in this period when appropriate local hemostatic measures are taken. Based on these results, a shorter aspirin intake cessation period may be allowable in complex dental procedures and surgery for which a longer aspirin intake cessation period (7–10 days) is recommended based on the American College of Chest Physicians guidelines.
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