Compared with IVUS, contrast-enhanced 64-MDCT has a good ability to identify and quantify coronary atherosclerotic plaques. However, the reliable differentiation of the composition of noncalcified plaques is still limited.
BackgroundThe aim of this study was to evaluate the prognostic values of five lymphocyte-based inflammatory indices (platelet-lymphocyte ratio [PLR], neutrophil-lymphocyte ratio [NLR], monocyte-lymphocyte ratio [MLR], systemic immune inflammation index [SII], and system inflammation response index [SIRI]) in patients with acute coronary syndrome (ACS).MethodsA total of 1,701 ACS patients who underwent percutaneous coronary intervention (PCI) were included in this study and followed up for major adverse cardiovascular events (MACE) including all-cause death, non-fatal ischemic stroke, and non-fatal myocardial infarction. The five indices were stratified by the optimal cutoff value for comparison. The association between each of the lymphocyte-based inflammatory indices and MACE was assessed by the Cox proportional hazards regression analysis.ResultsDuring the median follow-up of 30 months, 107 (6.3%) MACE were identified. The multivariate COX analysis showed that all five indices were independent predictors of MACE, and SIRI seemingly performed best (Hazard ratio [HR]: 3.847; 95% confidence interval [CI]: [2.623–5.641]; p < 0.001; C-statistic: 0.794 [0.731–0.856]). The addition of NLR, MLR, SII, or SIRI to the Global Registry of Acute Coronary Events (GRACE) risk score, especially SIRI (C-statistic: 0.699 [0.646–0.753], p < 0.001; net reclassification improvement [NRI]: 0.311 [0.209–0.407], p < 0.001; integrated discrimination improvement [IDI]: 0.024 [0.010–0.046], p < 0.001), outperformed the GRACE risk score alone in the risk predictive performance.ConclusionLymphocyte-based inflammatory indices were significantly and independently associated with MACE in ACS patients who underwent PCI. SIRI seemed to be better than the other four indices in predicting MACE, and the combination of SIRI with the GRACE risk score could predict MACE more accurately.
Nitrous acid (HONO), as a precursor of the hydroxyl radical (OH), plays an important role in the photochemistry of the troposphere, especially in the polluted urban atmosphere. A field campaign was conducted to measure atmospheric HONO concentration and that of other pollutants (such as NO 2 and particle mass concentration) in the autumn of 2009 at Shanghai urban areas. HONO mixing ratios were simultaneously measured by three different techniques: long path absorption photometer (LOPAP), differential optical absorption spectroscopy (DOAS) and chemical ionization mass spectrometer (CIMS). The measurements showed that the mixing ratios of HONO were highly variable and depended strongly on meteorological parameters. The HONO levels ranged from 0.5 to 7 ppb with maximum values during early morning and minimum levels during late afternoon. The three instruments reproduced consistent diurnal pattern of HONO concentrations with higher concentration during the night compared to the daylight hours. Comparison of HONO LOPAP /HONO CIMS ratios during daytime and nighttime periods exhibited a non-systematic disagreement of 0.93 and 1.16, respectively. This would indicate different chemical compositions of sampled air for the LOPAP and the CIMS instruments during daytime and nighttime periods, which have possibly affected measurements. Mean HONO concentration reported by LOPAP was 33 % higher than by DOAS on the whole period with no significant difference between daytime and nighttime periods. This revealed a systematic deviation from both instruments. The present data provides complementary information of HONO ambient levels in the atmosphere of Shanghai urban areas.
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