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European Heart Journal. Acute... Nov 2023The role of coronary calcification on clinical outcomes among different revascularization strategies in patients presenting with acute coronary syndromes (ACSs) has been...
AIMS
The role of coronary calcification on clinical outcomes among different revascularization strategies in patients presenting with acute coronary syndromes (ACSs) has been rarely investigated. The aim of this investigation is to evaluate the role of coronary calcification, detected by coronary angiography, in the whole spectrum of patients presenting with acute ACS.
METHODS AND RESULTS
The present study was a post hoc analysis of the MATRIX programme. The primary endpoint was major adverse cardiovascular events (MACE), defined as the composite of all-cause mortality, myocardial infarction (MI), or stroke up to 365 days. Among the 8404 patients randomized in the MATRIX trial, data about coronary calcification were available in 7446 (88.6%) and therefore were included in this post hoc analysis. Overall, 875 patients (11.7%) presented with severe coronary calcification, while 6571 patients (88.3%) did not present severe coronary calcification on coronary angiography. Fewer patients with severe coronary calcification underwent percutaneous coronary intervention whereas coronary artery bypass grafting or medical therapy-only was more frequent compared with patients without severe calcification. At 1-year follow-up, MACE occurred in 237 (27.1%) patients with severe calcified coronary lesions and 985 (15%) patients without severe coronary calcified lesions [hazard ratio (HR) 1.91; 95% confidence interval (CI) 1.66-2.20, P < 0.001]. All-cause mortality was 8.6% in patients presenting with and 3.7% in those without severe coronary calcification (HR 2.38, 1.84-3.09, P < 0.001). Patients with severe coronary calcification incurred higher rate of MI (20.1% vs. 11.5%, HR 1.81; 95% CI 1.53-2.1, P < 0.001) and similar rate of stroke (0.8% vs. 0.6%, HR 1.35; 95% CI 0.61-3.02, P = 0.46).
CONCLUSION
Patients with ACS and severe coronary calcification, as compared to those without, are associated with worse clinical outcomes irrespective of the management strategy.
Topics: Humans; Acute Coronary Syndrome; Coronary Artery Bypass; Coronary Artery Disease; Myocardial Infarction; Percutaneous Coronary Intervention; Randomized Controlled Trials as Topic; Risk Factors; Stroke; Treatment Outcome
PubMed: 37812760
DOI: 10.1093/ehjacc/zuad122 -
Experimental and Therapeutic Medicine Jul 2024Sturge-Weber syndrome (SWS) type III, a rare neurocutaneous disorder, presents diagnostic challenges due to its variable clinical manifestations. The present study...
Sturge-Weber syndrome (SWS) type III, a rare neurocutaneous disorder, presents diagnostic challenges due to its variable clinical manifestations. The present study focuses on enhancing the understanding of this syndrome by conducting a detailed analysis of two pediatric cases and providing a comprehensive review of the existing literature. The cases, managed at the Children's Hospital Affiliated to Shandong University (Jinan, China), highlight the diverse clinical presentations and successful management strategies for SWS type III. In the first case, a 4-year-old male patient exhibited paroxysmal hemiplegia, epileptic seizures and cerebral angiographic findings indicative of left pia mater and venous malformation. The second case involved a 2.5-year-old male patient presenting with recurrent seizures and angiographic findings on the right side. Both cases underscore the importance of considering epileptic seizures, acquired and transient hemiplegia and cognitive impairments in the diagnosis of SWS type III. The present study provides insights into the effective use of both pharmacological and surgical interventions, drawing from the positive outcomes observed in these cases. The findings emphasize the need for heightened awareness and a meticulous approach in diagnosing and treating SWS type III, contributing to the better management and prognosis of this condition.
PubMed: 38868613
DOI: 10.3892/etm.2024.12588 -
ACS Applied Materials & Interfaces Jun 2024Exploring the structure-performance relationship of high-voltage organic solar cells (OSCs) is significant for pushing material design and promoting photovoltaic...
Exploring the structure-performance relationship of high-voltage organic solar cells (OSCs) is significant for pushing material design and promoting photovoltaic performance. Herein, we chose a D-π-A type polymer composed of 4,8-bis(thiophene-2-yl)-benzo[1,2-:4,5-']dithiophene (BDT-T) and benzotriazole (BTA) units as the benchmark to investigate the effect of the fluorination number and position of the polymers on the device performance of the high-voltage OSCs, with a benzotriazole-based small molecule (BTA3) as the acceptor. , , and are the polymers with progressively increasing F atoms on the D units, while , , and are the polymers with further attachment of F atoms to the BTA units based on the above three polymers. Fluorination positively affects the molecular planarity, dipole moment, and molecular aggregations. Our results show that increases with the number of fluorine atoms, and fluorination on the D units has a greater effect on than on the A unit. with six fluorine atom substitutions achieves the highest (1.23 V). When four F atoms are located on the D units, the short-circuit current () and fill factor (FF) plummet, and before that, they remain almost constant. The drop in and FF in and based devices may be attributed to inefficient charge transfer and severe charge recombination. The :BTA3 system achieves the highest power conversion efficiency of 9.5% with a of 1.20 V due to the excellent balance between the photovoltaic parameters. Our study provides insights for the future application of fluorination strategies in molecular design for high-voltage organic photovoltaics.
PubMed: 38843444
DOI: 10.1021/acsami.4c05694 -
ACS Applied Materials & Interfaces Apr 2024The present work demonstrates the ultrafast carrier dynamics and third-order nonlinear optical properties of electrochemically fabricated free-standing porous silicon...
The present work demonstrates the ultrafast carrier dynamics and third-order nonlinear optical properties of electrochemically fabricated free-standing porous silicon (FS-PSi)-based optical microcavities via femtosecond transient absorption spectroscopy (TAS) and single-beam Z-scan techniques, respectively. The TAS (pump: 400 nm, probe: 430-780 nm, ∼70 fs, 1 kHz) decay dynamics are dominated by the photoinduced absorption (PIA, lifetime range: 4.7-156 ps) as well as photoinduced bleaching (PIB, 4.3-324 ps) for the cavity mode (λ) and the band edges. A fascinating switching behavior from the PIB (-ve) to the PIA (+ve) has been observed in the cavity mode, which shows the potential in ultrafast switching applications. The third-order optical nonlinearities revealed an enhanced two-photon absorption coefficient (β) in the order of 10 mW along with the nonlinear refractive index () in the range of 10 m W. Furthermore, a real-time sensing application of such FS-PSi microcavities has been demonstrated for detecting organic solvents by simultaneously monitoring the kinetics in reflection and transmission mode.
PubMed: 38514247
DOI: 10.1021/acsami.4c00526 -
Heart, Lung & Circulation Jun 2024Safety is of critical importance to chronic total occlusion (CTO) percutaneous coronary intervention (PCI). This global consensus statement provides guidance on how to...
Safety is of critical importance to chronic total occlusion (CTO) percutaneous coronary intervention (PCI). This global consensus statement provides guidance on how to optimise the safety of CTO) PCI, addressing the following 12 areas: 1. Set-up for safe CTO PCI; 2. Guide catheter--associated vessel injuries; 3. Hydraulic dissection, extraplaque haematoma expansion, and aortic dissections; 4. Haemodynamic collapse during CTO PCI; 5. Side branch occlusion; 6. Perforations; 7. Equipment entrapment; 8. Vascular access considerations; 9. Contrast-induced acute kidney injury; 10. Radiation injury; 11 When to stop; and, 12. Proctorship. This statement complements the global CTO crossing algorithm; by advising how to prevent and deal with complications, this statement aims to facilitate clinical practice, research, and education relating to CTO PCI.
PubMed: 38839467
DOI: 10.1016/j.hlc.2023.11.030 -
Rinsho Shinkeigaku = Clinical Neurology Jan 2024The first case was a 75-year-old woman with intermittent sensory impairment of the left hand. FLAIR of the head MRI revealed hyperintensity along the pia mater in the...
The first case was a 75-year-old woman with intermittent sensory impairment of the left hand. FLAIR of the head MRI revealed hyperintensity along the pia mater in the right parieto-temporal lobe with few microbleeds. Our second case was a 78-year-old man who presented with motor aphasia. His MRI showed swollen cortex on FLAIR and cortical hemosiderosis on T* weighted imaging of the right cerebral hemisphere. Pathological findings indicated the first case as cerebral amyloid angiopathy (CAA)-related inflammation and the second case as CAA. Additionally, after brain biopsy, widespread white matter lesions were detected in the area surrounding the biopsy site. However, both patients showed improvement without immunotherapy. Therefore, it is important to consider whether immunotherapy is required when white matter lesions appear in the area surrounding the biopsy site.
Topics: Male; Female; Humans; Aged; White Matter; Cerebral Amyloid Angiopathy; Magnetic Resonance Imaging; Immunotherapy; Biopsy; Cerebral Hemorrhage
PubMed: 38072444
DOI: 10.5692/clinicalneurol.cn-001887