Identification of platelet hyper-reactivity measured with a portable device immediately after percutaneous coronary intervention predicts in stent thrombosis

Introduction: Platelet hyper-reactivity, despite a standard anti-thrombotic therapy, is a recognized risk factor for recurrent myocardial ischemia and in-stent thrombosis following PCI. We have investigated whether this detrimental condition, measured by collagen-epinephrine closure times (CEPI-CT) with the Platelet Function Analyzer (PFA-100) device could predict IST defined as the composite of cardiovascular death or myocardial infarction. Materials and methods: CEPI-CT was measured in 256 consecutive patients with stable angina (n=103) or ACS (n=153) 30?8 h after PCI (T0) and 1 month later (T1). All patients were followed up for a mean period of 9 months. Platelet hyperactivity was defined as a CEPI-CTb190 s. Results: Baseline CEPI-CTb190 s was associated with a higher rate of death or MI (LogRank χ2 =4.23, p=0.039) as compared with CEPI-CTN190 s (4.6% vs. 0.7%). Multivariable analysis after adjustment for other risk factors confirmed that baseline CEPI-CTb190 s was an independent correlate for death or MI (Hazard ratio 6.981, p=0.008). At T1 there was a significant prolongati

TCT-737 MONITORING THE LEARNING CURVE AND QUALITY OF CARE IN TAVI PROCEDURES BY CUSUM ANALYSIS

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Elevated soluble receptor for advanced glycation end product levels in patients with acute coronary syndrome and positive cardiac troponin I

Objectives High levels of soluble receptor for advanced glycation end products (sRAGE) have been shown to have an atheroprotective role; however, no data are available on this molecule in acute coronary syndromes (ACS). We evaluated sRAGE levels in patients with non-ST segment elevation ACS (NSTE-ACS) or with chronic stable angina. Methods We studied 265 patients, 190 of whom had NSTE-ACS and 75 had chronic stable angina. Results Plasma sRAGE values were comparable in the two groups (P= 0.19). However, in the patients with NSTEACS,sRAGE levels were significantly higher in patients with cardiac troponin-I (cTnI) of more than or equal to 0.04 lg/l compared with those with cTnI of less than 0.04 lg/l [758 pg/ml (493-1536 pg/ml) vs. 454 pg/ml (167-899 pg/ml); P = 0.0037]. A significant correlation(r= 0.323, P = 0.0045) was found between sRAGE and cTnI levels in patients with NSTE-ACS.Conclusion Plasma sRAGE levels are elevated in patients with NSTE-ACS with positive cTnI, suggesting that they could be related to myocardial cell damage

Use of different subjective health indicators to assess health inequalities in an urban immigrant population in north-western Italy: a cross-sectional study

BACKGROUND: Despite the steady growth of the immigrant population in Italy, data on the health status of immigrants are scarce. Our main goals were to measure Health-Related Quality of Life (HRQoL), Self-Rated Health (SRH) and morbidity among immigrants in Genoa. We aimed to assess the relative contribution of some social, structural and behavioral determinants to “within-group” health disparities. METHODS: We enrolled 502 subjects by means of snowball sampling. The SF-12 questionnaire, integrated with socio-demographic and health-related items, was used. Multivariate logistic and Poisson regression models were applied in order to identify characteristics associated with poor SRH, lower SF-12 scores and prevalence of self-reported morbidities. RESULTS: Subjects showed relatively moderate levels of HRQoL (median physical and mental scores of 51.6 and 47.3, respectively) and about 15% of them rated their health as fair or poor. Lower scores in the physical dimension of HRQoL were associated with the presence of morbidities and immigration for work and religious reasons, while those who had migrated for religious and family reasons displayed a lower probability of lower scores in the mental dimension of HRQoL. Poor SRH was associated with female gender, overweight/obesity and presence of morbidities. Moreover, compared with immigrants from countries with a low human development index, immigrants from highly developed societies showed significantly lower odds of reporting poor SRH. About one-third of respondents reported at least one medical condition, while the prevalence of multi-morbidity was 10%. Females, over 45-year-olds, overweight and long-term immigrants had a higher prevalence of medical conditions. CONCLUSIONS: Our study confirms the presence of health inequalities within a heterogeneous immigrant population. HRQoL, SRH and morbidity are valid, relatively rapid and cheap tools for measuring health inequalities, though they do so in different ways. These indicators should be used with caution and, if possible, simultaneously, as they could help to identify and to monitor more vulnerable subjects among immigrants

A New Elastomeric Biomaterial for Arterial Diseases Applications

The covering of self-expandable stents (S-ESs) with elastic biocompatible membrane may avoid the atherosclerotic plaque prolapse between the stent struts into the lumen. In this work it is proposed a new elastomeric biomaterial, combined with a spray-technique, to realise a thin membrane for covering S-ESs. The membrane resulted adherent to metallic struts and able to follow stent deformation. The new biomaterial, an elastomeric silicone (polydimethylsiloxane PDMS) based poly(ether)urethane (PEtU/PDMS), deposited on the S-ESs by the spray-technique, showed in vitro good adhesion to metallic struts, even after deformation and recoil, and did not compromise its elastic behaviour. Capitalising on the good biocompatibility and low trombogenicity demonstrated by the material within previous studies it is expected that it can be used successfully for S-ESs covering for iliac-femoral applications

Percutaneous coronary intervention in an anomalously arising totally occluded circumflex coronary artery

AbstractCongenital coronary anomalies are present in approximately 1% of the patients referred to cardiac catheterization. The present case describes a successful percutaneous coronary intervention in totally occluded left circumflex coronary artery (LCx) with an anomalous origin from right sinus of Valsalva. To the best of our knowledge this is the first case presented of successful recanalization of a chronic total occlusion in an anomalously arising LCx. The case highlights the feasibility of such a challenging procedure on the basis of the knowledge of coronary anatomy and the selection of appropriate guiding catheters and coronary wires

Effect of some candidate genes on meat characteristics of three cattle breeds.

With the aim to assess if some molecular markers can help to select animals for meat characteristics, we studied 84 individuals equally representing the Marchigiana, Maremmana, and Holstein Friesian cattle breeds genotyped at 288 SNPs located within candidate genes. Several SNPs were found associated with meat quality parameters but with P which was higher than the Bonferroni threshold. However, several SNPs had a low P at different times during meat maturation, suggesting their involvement in the meat quality variation. Of particular interest for the biological role and potential for selection were: cathepsin G affecting MFI, IGF1R affecting pH and collagen XVIII affecting colour