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

Assessing quantitative taxon-specific grass pollen biodiversity in time and space using targeted molecular analysis of aerial environmental DNA

Background : In Europe, grass pollen is the single most important outdoor aeroallergen; 27% of the population are sensitised to grass pollen leading to extensive negative health outcomes. Of particular importance to human health is allergic asthma, which can lead to hospitalisation and can be fatal. Sensitivity towards grass pollen varies between species, of which there are over 150 in the UK. However, due to few unique morphological features, grass pollen from different species cannot be discriminated eas-ily using traditional observational methods. Currently, there is no way of detecting, modelling or forecasting the aerial- dispersion of taxon-specific pollen from the extensive biodiversity of UK grasses. PollerGENis an interdisciplinary NERC project, in collabo-ration with the UK Met Office with the aim of advancing the way that pollen dispersion is measured and forecast. Emerging molecu-lar data (targeted sequencing of DNA taxonomy markers, i.e. me-tabarcoding) have indicated that the species composition of aerial grass pollen communities varies significantly both temporally and spatially across the grass flowering season. Yet, the precise quan-titative nature of the data, both from laboratory and field trials, remains unconfirmed. Method : Here, we used quantitative PCR (qPCR) to analyse aerial environmental DNA (eDNA) from up to 14 sites across the UK dur-ing the 2016- 2017 grass pollen seasons. Our aim was to quantify phenological and geographical trends exhibited in pollen deposition of key known allergenic grasses, including Dactylis glomerata, Lolium perenne and Phleum pratense . Results : The results confirm that the grass flowering season is het-erogeneous, showing quantitative differences in taxon composition throughout the summer months. The data demonstrate that sea-sonal exposure to different types of grass pollen is not static, but features shifting abundances of different species of pollen that can be linked to health outcomes. Conclusion : The empirical findings will be discussed in addition to providing a broader perspective of the PollerGEN program, that in-tegrates species vegetation mapping, advanced aerobiological mod-elling, environmental genomic, metabarcoding and qPCR genetic analyses and human epidemiology