Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery

<p>Abstract</p> <p>Background</p> <p>Progression of atherosclerosis in coronary artery disease is observed through consecutive angiograms. Prognosis of this progression in patients randomized to different treatments has not been established. This study compared progression of coronary artery disease in native coronary arteries in patients undergoing surgery, angioplasty, or medical treatment.</p> <p>Methods</p> <p>Patients (611) with stable multivessel coronary artery disease and preserved ventricular function were randomly assigned to CABG, PCI, or medical treatment alone (MT). After 5-year follow-up, 392 patients (64%) underwent new angiography. Progression was considered a new stenosis of ≥ 50% in an arterial segment previously considered normal or an increased grade of previous stenosis > 20% in nontreated vessels.</p> <p>Results</p> <p>Of the 392 patients, 136 underwent CABG, 146 PCI, and 110 MT. Baseline characteristics were similar among treatment groups, except for more smokers and statin users in the MT group, more hypertensives and lower LDL-cholesterol levels in the CABG group, and more angina in the PCI group at study entry. Analysis showed greater progression in at least one native vessel in PCI patients (84%) compared with CABG (57%) and MT (74%) patients (p < 0.001). LAD coronary territory had higher progression compared with LCX and RCA (P < 0.001). PCI treatment, hypertension, male sex, and previous MI were independent risk factors for progression. No statistical difference existed between coronary events and the development of progression.</p> <p>Conclusion</p> <p>The angioplasty treatment conferred greater progression in native coronary arteries, especially in the left anterior descending territories and treated vessels. The progression was independently associated with hypertension, male sex, and previous myocardial infarction.</p

A lactoperoxidase-based flow injection amperometric biosensor for iodide detection

The following contains work carried out into the preparation of an amperometric enzymatic biosensor (M.P. Byfield, R.A. Abuknesha, Biochemical aspects of biosensors. Biosens. Bioelectron. 9 (1994) 373-400; C.R. Lowe, An introduction to the concepts and technology of biosensors. Biosensors 1 (1985) 3-16; J.S. Schultz, Biosensors. Sci. Am. 8 1991 48-55) using the enzyme, lactoperoxidase (LPOD), for the detection of iodide. In this paper, a study of two major avenues which were undertaken to achieve an iodide biosensor, using electrochemical transduction techniques, are discussed. The first of these focuses on the use of LPOD in solution using both DPBS and acetate buffers, while later work has concentrated on investigations into the immobilised enzyme. The former has been shown to measure iodide concentrations of less than 0.1 mu mol/l while the latter can be used to detect iodide levels lower than 10 mu mol/l. The difficulties and drawbacks associated with both these systems are discussed. (C) 1998 Elsevier Science S.A. All rights reserved.[...