Minimally invasive coronary artery bypass grafting versus percutaneous transluminal coronary angioplasty with stenting in isolated high-grade stenosis of the proximal left anterior descending coronary artery: Six months' angiographic and clinical follow-up of a prospective randomized study

AbstractObjective: We sought to compare minimally invasive coronary artery bypass grafting (surgical intervention) with percutaneous transluminal coronary angioplasty with primary stenting (stenting) in patients having an isolated high-grade stenosis (American College of Cardiology/American Heart Association classification type B2 or C) of the proximal left anterior descending coronary artery. At 6 months, both procedures were compared on the basis of quantitative angiography and clinical outcome. Methods: Both treatments were compared in a single-center, prospective, randomized study. The primary end point of this study was quantitative angiographic outcome at 6 months. The secondary end point was 6-month clinical outcome. Statistical analysis was performed in accordance with the intention-to-treat principle. Results: From March 1997 to September 1999, patients with angina pectoris caused by an isolated high-grade stenosis of the proximal left anterior descending coronary artery were randomly assigned to surgical intervention (n = 51) or stenting (n = 51). At 6 months, quantitative coronary angiography showed an anastomotic stenosis rate of 4% after surgical intervention and a restenosis rate of 29% after stenting (P <.001). Periprocedural events did not significantly differ between surgical intervention and stenting. After surgical intervention, 2 patients died; no patients died after stenting. After 6 months, no significant difference was found for major adverse cardiac or cerebral events and need for repeat target vessel revascularization. After 6 months, return of angina pectoris, physical work capacity, and use of antianginal drugs did not significantly differ between treatments. Conclusions: After 6 months, surgical intervention had a significantly better angiographic outcome than stenting in patients with an isolated high-grade stenosis of the proximal left anterior descending coronary artery. Clinical outcome did not significantly differ between treatments.J Thorac Cardiovasc Surg 2002;124:130-

Potential Benefits of Exercise on Blood Pressure and Vascular Function

Physical activity seems to enhance cardiovascular fitness during the course of the lifecycle, improve blood pressure, and is associated with decreased prevalence of hypertension and coronary heart disease. It may also delay or prevent age-related increases in arterial stiffness. It is unclear if specific exercise types (aerobic, resistance, or combination) have a better effect on blood pressure and vascular function. This review was written based on previous original articles, systematic reviews, and meta-analyses indexed on PubMed from years 1975 to 2012 to identify studies on different types of exercise and the associations or effects on blood pressure and vascular function. In summary, aerobic exercise (30 to 40 minutes of training at 60% to 85% of predicted maximal heart rate, most days of the week) appears to significantly improve blood pressure and reduce augmentation index. Resistance training (three to four sets of eight to 12 repetitions at 10 repetition maximum, 3 days a week) appears to significantly improve blood pressure, whereas combination exercise training (15 minutes of aerobic and 15 minutes of resistance, 5 days a week) is beneficial to vascular function, but at a lower scale. Aerobic exercise seems to better benefit blood pressure and vascular function

Aspects of endothelial function testing in coronary vascular disease

The endothelium plays a key role in onset and progression of coronary vascular disease, endothelial dysfunction has indicated prospectively to be related with the occurrence of new coronary vascular events, and there is support that dysfunction is not irreversible. Intracoronary acetylcholine testing can only be justified if it is a safe test, with prognostic significance in large cohort studies, without an alternative such as forearm measurements. This thesis describes the aspects of endothelial function testing in coronary vascular disease by discussing the following statements: a. Evaluation of different methods to measure coronary endothelial function in patients with angina pectoris: pre and contra b. Aspects of acetylcholine-induced coronary endothelial function testing in clinical practice: different patients have different outcome c. Treatment of endothelial dysfunction with ACE-inhibitors: a pre-clinical setting The different methods of statement a. are described in section II, clinical practice is shown in section III, and experimental ACE-inhibitor therapy in section IV.

Perceived realism and the CSI-effect

Anecdotal claims from legal professionals suggest that jurors are increasingly expecting DNA evidence in criminal trials, due to the popularity of crime-drama television programs such as Crime Scene Investigation (CSI). This study extends research on the “CSI-effect” by investigating whether mock jurors’ verdict decisions differ as a function of the perception that television reflects real-life practices (perceived realism), evidence type, and evidence strength. Participants read a trial transcript in which the prosecution presented either strong or weak DNA/fingerprint/eyewitness evidence. They then provided a verdict and answered a questionnaire to assess their perceived realism of television programs, including crime-drama. For all three types of evidence, jurors high in perceived realism were more likely to convict than those low in perceived realism. Additionally, jurors were more likely to vote guilty if presented with DNA or fingerprint evidence compared to eyewitness testimony, while evidence strength only influenced verdicts in the eyewitness conditions. Results suggest that perceived realism is not associated with jurors’ expectations that DNA evidence be presented in court, and thus do not provide support for the purported CSI-effect. Perceived realism may actually be a desirable trait for prosecutors, as jurors high in perceived realism were in general more likely to convict

Simultaneously controlling conformational and operational stability of single-chain polymeric nanoparticles in complex media

Single-chain polymeric nanoparticles (SCPNs) comprising a solvatochromic pyrazoline adduct show conformational and operational stability in complex media and in cellular compartments; the connectivity of the adduct is crucial in modulating interactions with the surrounding media