Association of Obstructive Sleep Apnea With Cardiovascular Outcomes in Patients With Acute Coronary Syndrome.

Background The prognostic significance of obstructive sleep apnea ( OSA ) in patients with acute coronary syndrome ( ACS ) in the contemporary era is unclear. We performed a large, prospective cohort study and did a landmark analysis to delineate the association of OSA with subsequent cardiovascular events after ACS onset. Methods and Results Between June 2015 and May 2017, consecutive eligible patients admitted for ACS underwent cardiorespiratory polygraphy during hospitalization. OSA was defined as an apnea-hypopnea index ≥15 events·h-1. The primary end point was major adverse cardiovascular and cerebrovascular event ( MACCE ), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure. OSA was present in 403 of 804 (50.1%) patients. During median follow-up of 1 year, cumulative incidence of MACCE was significantly higher in the OSA group than in the non- OSA group (log-rank, P=0.041). Multivariate analysis showed that OSA was nominally associated with incidence of MACCE (adjusted hazard ratio, 1.55; 95% CI, 0.94-2.57; P=0.085). In the landmark analysis, patients with OSA had 3.9 times the risk of incurring a MACCE after 1 year (adjusted hazard ratio, 3.87; 95% CI, 1.20-12.46; P=0.023), but no increased risk was found within 1-year follow-up (adjusted hazard ratio, 1.18; 95% CI, 0.67-2.09; P=0.575). No significant differences were found in the incidence of cardiovascular death, myocardial infarction, and ischemia-driven revascularization, except for a higher rate of hospitalization for unstable angina in the OSA group than in the non- OSA group (adjusted hazard ratio, 2.10; 95% CI, 1.09-4.05; P=0.027). Conclusions There was no independent correlation between OSA and 1-year MACCE after ACS . The increased risk associated with OSA was only observed after 1-year follow-up. Efficacy of OSA treatment as secondary prevention after ACS requires further investigation

Clinical significance of obstructive sleep apnea in patients with acute coronary syndrome in relation to diabetes status.

Objective: The prognostic significance of obstructive sleep apnea (OSA) in patients with acute coronary syndrome (ACS) according to diabetes mellitus (DM) status remains unclear. We aimed to elucidate the association of OSA with subsequent cardiovascular events in patients with ACS with or without DM. Research design and methods: In this prospective cohort study, consecutive eligible patients with ACS underwent cardiorespiratory polygraphy between June 2015 and May 2017. OSA was defined as an Apnea Hypopnea Index ≥15 events/hour. The primary end point was major adverse cardiovascular and cerebrovascular events (MACCEs), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure. Results: Among 804 patients, 248 (30.8%) had DM and 403 (50.1%) had OSA. OSA was associated with 2.5 times the risk of 1 year MACCE in patients with DM (22.3% vs 7.1% in the non-OSA group; adjusted HR (HR)=2.49, 95% CI 1.16 to 5.35, p=0.019), but not in patients without DM (8.5% vs 7.7% in the non-OSA group, adjusted HR=0.94, 95% CI 0.51 to 1.75, p=0.85). Patients with DM without OSA had a similar 1 year MACCE rate as patients without DM. The increased risk of events was predominately isolated to patients with OSA with baseline glucose or hemoglobin A1c levels above the median. Combined OSA and longer hypoxia duration (time with arterial oxygen saturation22 min) further increased the MACCE rate to 31.0% in patients with DM. Conclusions: OSA was associated with increased risk of 1 year MACCE following ACS in patients with DM, but not in non-DM patients. Further trials exploring the efficacy of OSA treatment in high-risk patients with ACS and DM are warranted

Reviews on Mechanisms of In Vitro

It is widely acknowledged that the excessive reactive oxygen species (ROS) or reactive nitrogen species (RNS) induced oxidative stress will cause significant damage to cell structure and biomolecular function, directly or indirectly leading to a number of diseases. The overproduction of ROS/RNS will be balanced by nonenzymatic antioxidants and antioxidant enzymes. Polysaccharide or glycoconjugates derived from natural products are of considerable interest from the viewpoint of potent in vivo and in vitro antioxidant activities recently. Particularly, with regard to the in vitro antioxidant systems, polysaccharides are considered as effective free radical scavenger, reducing agent, and ferrous chelator in most of the reports. However, the underlying mechanisms of these antioxidant actions have not been illustrated systematically and sometimes controversial results appeared among various literatures. To address this issue, we summarized the latest discoveries and advancements in the study of antioxidative polysaccharides and gave a detailed description of the possible mechanisms

Advances in Polygonatum sibiricum polysaccharides: Extraction, purification, structure, biosynthesis, and bioactivity

Polygonatum sibiricum has been used as food and medicine for thousands of years, and P. sibiricum polysaccharides (PSPs) have become the hot research spot due to their various health-promoting functions. Numerous studies have shown that PSPs possess huge potential in the application of functional food and medicine fields. However, the research status and features of the preparation process, molecular structure, and bioactivities of PSPs are unclear. Therefore, this review makes a comprehensive summary and proposes new insights and guidelines for the extraction, purification, structural features, biosynthesis, and multiple bioactivities of PSPs. Notably, it is concluded that PSPs mainly contain several types of polysaccharides, including fructan, pectin, galactomannan, glucomannans, arabinogalactan, and galactan, and multiple bioactivates, including osteogenic activity, anti-obesity, anti-diabetes, anti-depression, antioxidant, antiglycation, and protective effect against neurotoxicity and gut microbiota regulating activity. This review contributes to the structure–function study and resource utilization of P. sibiricum and its polysaccharides in food fields

Angiotensin-converting Enzyme Inhibitors Decrease the Risk of Cardiac Rupture after Acute Myocardial Infarction: A Meta-analysis of Randomized Controlled Trials

Background: ACEI therapy decreases mortality in patients with acute MI. However, the effects of ACEIs on CR are unclear. Methods: A comprehensive search of PUBMED, EMBASE, ISI Web of Science, MEDLINE and the Cochrane Register of Controlled Trials before July 2022 was conducted to identify all RCTs on ACEIs that recorded CR as an outcome. Review Manager 5.3 was used to analyze the data. Results: Five RCTs including 26,383 patients with MI were identified; 71 of the 13,159 patients receiving ACEIs and 107 of the 13,224 control patients were verified to have CR. ACEI therapy started within 24 hours after the onset of acute MI significantly decreased the risk of CR, by 33% (RR: 0.67, 95% CI: 0.50–0.90, P=0.008). Conclusions: Early administration of ACEIs (within 24 hours after the onset of acute MI) decreased the incidence of CR in patients with acute MI

Structural characterization of an α-1, 6-linked galactomannan from natural Cordyceps 2 sinensis

An α-1, 6-linked galactomannan was isolated and purified from natural Cordyceps sinensis. The fine structure analysis of this polysaccharide was elucidated based on partial acid hydrolysis, monosaccharide composition, methylation and 1D/2D nuclear magnetic resonance (NMR) spectroscopy. Monosaccharide composition analysis revealed that this polysaccharide was mainly composed of galactose (68.65%), glucose (6.65%) and mannose (24.02%). However, after partial acid hydrolysis the percentages of galactose, glucose and mannose were changed to 3.96%, 13.82% and 82.22%, respectively. The molecular weight of this polysaccharide was 7207. Methylation and NMR analysis revealed that this galactomannan had a highly branched structure, mainly consisted of a mannan skeleton and galactofuranosyl chains. The structure of galactofuranosyl part was formed by alternating (1 → 5)-lined β-Galf and (1 → 6)-liked β-Galf or a single (1 → 6)-liked β-Galf, attaching to the O-2 and O-4 of the mannose chain, and terminated at β-T-Galf. The mannan core was revealed by analyzing the partial acid hydrolysate of the galactomannan and the structure was composed of (1 → 6)-linked α-Manp backbone, with substituted at C-2 by short chains of 2-substituted Manp or Galf branches

Pseudoaneurysm with Median Nerve Injury Caused by Right Radial Artery Puncture: A Case Report

Background: Pseudoaneurysm with median nerve injury is a serious complication of radial artery puncture. It is very important to summarize the prevention and treatment experience of this complication through case discussion. Case report: A 66-year-old woman was admitted to the hospital because of “paroxysmal chest tightness and suffocation for 5 days.” Coronary angiography was performed. During insertion of the arterial sheath, the patient experienced severe pain in the right forearm, which radiated to the palm. The puncture sheath did not return blood after the sheath core was withdrawn. The sheath was removed and local compression was used to stop bleeding. There was no obvious bleeding at the puncture point, and the compression was removed 6 hours after the procedure. Local swelling and increased tension were seen in the right forearm. At the 1-week follow-up she exhibited swelling, high local tension, small blisters, and bluish-purple skin of the right forearm, with an acceptable right radial artery pulsation. She had severe pain in the affected limb, which radiated to the thumb, index finger, and middle finger. Case discussion: We discuss the causes of and treatment measures for pseudoaneurysm with median nerve injury caused by radial artery puncture

Continuous Positive Airway Pressure Therapy and Long-Term Outcomes in Patients with Coronary Artery Disease and Obstructive Sleep Apnea: A Meta-Analysis of Randomized Trials

Background: Obstructive sleep apnea (OSA) is highly common in patients with coronary artery disease (CAD) and it is a strong predictor of subsequent cardiovascular events. However, whether treatment with continuous positive airway pressure (CPAP) can decrease this risk remains controversial. Methods: PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov were systematically searched to identify randomized clinical trials reporting cardiovascular events from database inception to February 12, 2022. Results : Four trials with 3043 participants were included. The median follow-up duration ranged from 3 to 4.75 years. Compared with usual care alone, CPAP was not associated with decreased MACCE risk (RR 0.96, 95% CI 0.77–1.21, P = 0.75), and the results were consistent regardless of CPAP adherence (≥4 hours/night vs. <4 hours/night, RR 0.48, 95% CI 0.20–1.16). Similarly, no significant differences were observed between groups in the risks of all-cause death (RR 0.81, 95% CI 0.52–1.26), cardiovascular death (RR 0.70, 95% CI 0.36–1.33), myocardial infarction (RR 1.08, 95% CI 0.73–1.60), revascularization (RR 1.03, 95% CI 0.77–1.38), and cerebrovascular events (RR 0.77, 95% CI 0.23–2.61). Conclusion: Existing evidence does not support an association between CPAP treatment and decreased risk of recurrent cardiovascular events in patients with CAD and OSA, regardless of adherence to CPAP

Effects of Differently Processed Carrots on Ulcerative Colitis in Mice

The incidence of ulcerative colitis (UC) has been increasing in recent years. Due to the limitations of traditional drug therapies for UC, natural foods that can prevent this disease and alleviate its symptoms are becoming a research hot topic, but the effects of processing methods on their activity remain unknown. Therefore, the effects of three different processing methods (pulping, high-temperature cooking, and fermentation) on carotenoid and dietary fiber contents as well as carotenoid bioaccessibility in carrots were explored in this study. C57BL/6J mice were used to create a mouse model of UC induced by dextran sulfate sodium (DSS) and the mice received dietary intervention with freeze dried powder of carrots (5.05%, on a dry mass basis) for 14 days. Body mass change, disease activity index (DAI) and colon parameters (length, pathology, inflammatory factors, oxidative stress level, goblet cell number, tight junction protein expression, and short-chain fatty acid content) were analyzed to evaluate the effects of three differently processed carrots on UC. The results showed compared with pulping, high-temperature cooking and fermentation significantly decreased the soluble, insoluble and total dietary fiber contents of carrots (P < 0.05), increased the bioaccessibility of carotenoids (P < 0.05), while fermentation significantly increased the proportion of soluble dietary fiber in total dietary fiber (P < 0.05). Compared with the model group, all processed carrots could significantly inhibit the change of body mass loss and DAI (P < 0.05), decrease the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-6 (P < 0.05), increase the level of IL-10 (P < 0.05), and up-regulate the expression of tight junction proteins (ZO-1, claudin-1, and occludin) (P < 0.05). High-temperature cooked or fermented carrots could significantly alleviate colon shortening (P < 0.05), and relieve the pathological damage of colon tissue (P < 0.05). Meanwhile, fermented carrots could significantly inhibit the production of malondialdehyde (MDA) (P < 0.05), improve the decrease in the number of goblet cells (P < 0.05), increase the level of butyric acid (P < 0.05) and possess the best inhibitory effect on IL-6 production. In summary, differently processed carrots could ameliorate ulcerative colitis to different extends, the most pronounced effect being observed with fermented carrots