Gender and Acute Myocardial Infarction: Is There a Different Response to Thrombolysis?

AbstractObjectives. This study sought to 1) determine the effect of gender on early and late infarct-related artery patency and reocclusion after thrombolytic therapy for acute myocardial infarction; 2) examine the effect of gender on left ventricular function in response to injury/reperfusion; and 3) assess the independent contribution of gender to early (30-day) mortality after acute myocardial infarction.Background. Women have a higher mortality rate than men after myocardial infarction. However, the effect of gender on infarct-related coronary artery patency and left ventricular response to injury/reperfusion have not been fully defined in the thrombolytic era.Methods. Patency rates and global and regional left ventricular function were determined in patients at 90 min and 5 to 7 days after thrombolytic therapy for acute myocardial infarction. The effect of gender on infarct-related artery patency and left ventricular function was determined. Thirty-day mortality differences between women and men were compared.Results. Women were significantly older and had more hypertension, diabetes, hypercholesterolemia, heart failure and shock. They were less likely to have had a previous myocardial infarction, history of smoking or previous bypass surgery. Ninety-minute patency rates (Thrombolysis in Myocardial Infarction [TIMI] flow grade 3) in women and men were 39% and 38%, respectively (p = 0.5). Reocclusion rates were 8.7% in women versus 5.1% in men (p = 0.14). Women had more recurrent ischemia than men (21.4% vs. 17.0%, respectively, p = 0.01). Ninety-minute ejection fraction and regional ventricular function were clinically similar in women and men with TIMI 2 or 3 flow (ejection fraction [mean ± SD]: 63.4 ± 6% vs. 59.4 ± 0.7%, p = 0.02; number of chords: 21.4 ± 0.9 vs. 21.0 ± 1.9, p = 0.7; SD/chord: −2.4 ± 08 vs. −2.4 ± 0.2, p = 0.9, respectively). No clinically significant differences in left ventricular function were noted at 5- to 7-day follow-up. Women had a greater hyperkinetic response than men in the noninfarct zone (SD/chord: 2.4 ± 0.2 vs. 1.7 ± 0.1, p = 0.005). The 30-day mortality rate was 13.1% in women versus 4.8% in men (p ≤ 0.0001). After adjustment for other clinical and angiographic variables, gender remained an independent determinant of 30-day mortality.Conclusions. Women do not differ significantly from men with regard to either early infarct-related artery patency rates or reocclusion after thrombolytic therapy or ventricular functional response to injury/reperfusion. Gender was an independent determinant of 30-day mortality after acute myocardial infarction.(J Am Coll Cardiol 1997;29:35–42)

Angiographic Findings and Outcome in Diabetec Patients Treated With Thrombolytic Therapy for Acute Myocardial Infarction: The GUSTO-I Experience

OBJECTIVES: This study sought to determine whether diabetes mellitus, in the setting of thrombolysis for acute myocardial infarction, affects 1) early infarct-related artery patency and reocclusion rates; and 2) global and regional ventricular function indexes. We also sought to assess whether angiographic or baseline clinical variables, or both, can account for the known excess mortality after myocardial infarction in the diabetic population. BACKGROUND: Mortality after acute myocardial infarction in patients with diabetes is approximately twice that of nondiabetic patients. It is uncertain whether this difference in mortality is due to a lower rate of successful thrombolysis, increased reocclusion after successful thrombolysis, greater ventricular injury or a more adverse angiographic or clinical profile in diabetic patients. METHODS: Patency rates and global and regional left ventricular function were determined in patients enrolled in the GUSTO-I Angiographic Trial. Thirty-day mortality differences between those with and without diabetes were compared. RESULTS: The diabetic cohort had a significantly higher proportion of female and elderly patients, and th

Efeito de reguladores de crescimento sobre os teores de ácido ascórbico e carboidratos solúveis de morango (Fragaria hybridus)

Several growth regulators were sprayed on strawberry plants: SADH (5000 ppm), CCC (2000 ppm), IAA (10 ppm, 3 times), GA 10 ppm, 3 times) and GA (550 ppm), Ascorbic acid, dry weight and soluble carbohydrates contents of fruits were determined. Statistically differences were not observed between treatments and control. Dry weight varied from 7.62 to 9.53%. Ascorbic acid content varied from 35.88 to 71.81 mg/100 g on fresh weight basis. Mean values of soluble carbohydrates, in grams/100 g on fresh weight basis, were total (5.58), sucrose (1.01), glucose (1.63) and frutose (1.54).Foram feitas aplicações dos seguintes reguladores de crescimento em morango (Fragarm hybridus): SADH a 5000 ppm, CCC a 2000 ppm, ATA a 10 ppm (3 aplicações), ácido giberélico a 10 ppm (3 aplicações) e 550 ppm. Análises de peso seco, ácido ascórbico e carboidratos solúveis dos frutos foram efetuadas a fim de se estudar o efeito desses reguladores de crescimento. Não foram detectadas diferenças significativas entre os diversas tratamentos e o controle. O peso seco variou de 7,62 a 9,53%. O conteúdo de ácido ascórbico variou de 35,88 a 71,81 mg/100 g de peso fresco. Os teores médios de carboidratos solúveis, expresso em g/100 g peso fresco, foram: totais (5,58), sacarose (1,01), glucose (1,63) e frutose (1,54)

Genetic dissection of fruit quality traits in the octoploid cultivated strawberry highlights the role of homoeo-QTL in their control

Fruit quality traits are major breeding targets in the Rosaceae. Several of the major Rosaceae species are current or ancient polyploids. To dissect the inheritance of fruit quality traits in polyploid fleshy fruit species, we used a cultivated strawberry segregating population comprising a 213 full-sibling F1 progeny from a cross between the variety ‘Capitola’ and the genotype ‘CF1116’. We previously developed the most comprehensive strawberry linkage map, which displays seven homoeology groups (HG), including each four homoeology linkage groups (Genetics 179:2045–2060, 2008). The map was used to identify quantitative trait loci (QTL) for 19 fruit traits related to fruit development, texture, colour, anthocyanin, sugar and organic acid contents. Analyses were carried out over two or three successive years on field-grown plants. QTL were detected for all the analysed traits. Because strawberry is an octopolyploid species, QTL controlling a given trait and located at orthologous positions on different homoeologous linkage groups within one HG are considered as homoeo-QTL. We found that, for various traits, about one-fourth of QTL were putative homoeo-QTL and were localised on two linkage groups. Several homoeo-QTL could be detected the same year, suggesting that several copies of the gene underlying the QTL are functional. The detection of some other homoeo-QTL was year-dependent. Therefore, changes in allelic expression could take place in response to environmental changes. We believe that, in strawberry as in other polyploid fruit species, the mechanisms unravelled in the present study may play a crucial role in the variations of fruit quality

Inhibition of myointimal proliferation of the rat carotid artery by the peptides, angiopeptin and BIM 23034.

Proliferation of vascular smooth muscle is an early and major event in the formation of an atherosclerotic lesion. Here we report for the first time the inhibitory effects on myointimal proliferation of the rat carotid artery by a synthetic peptide, angiopeptin, and its closely related congener, BIM 23034. Proliferation was initiated in the carotid artery of anesthetized rats by air-drying of the endothelium. After 15 days the rats were killed and the carotid artery was pressure-fixed and subjected to morphologic analysis for evaluation of the degree of myointimal thickening. Five synthetic somatostatin-like peptides were tested by pretreating rats (20 and 50 micrograms/kg/rat s.c. daily) for 2 days prior to and for 5 days after the endothelial injury. Angiopeptin and the closely related octapeptide (BIM 23034) significantly inhibited myointimal thickening. Angiopeptin was also effective when the pretreatment period was reduced from 2 days to 30 min. The inhibitory effect of angiopeptin was further confirmed in an additional experiment involving [3H]thymidine incorporation. In this experiment angiopeptin (100 micrograms/kg/day s.c.) was also administered for 2 days prior to and five days following the endothelial injury and it significantly inhibited thymidine uptake. All the peptides tested inhibit the release of growth hormone. However, only angiopeptin and BIM 23034 inhibited myointimal proliferation. Thus the effect of angiopeptin and its congener is unlikely to be mediated through growth hormone. Since angiopeptin inhibits myointimal proliferation it may have clinical utility in preventing restenosis following angioplasty and coronary artery by-pass procedures