Insulin resistance predicts progression of de novo atherosclerotic plaques in patients with coronary heart disease: a one-year follow-up study

BACKGROUND: The aim of our study was to explore and evaluate the relationship between insulin resistance and progression of coronary atherosclerotic plaques. With the great burden coronary heart disease is imposing on individuals, healthcare professionals have already embarked on determining its potential modifiable risk factors in the light of preventive medicine. Insulin resistance has been generally recognized as a novel risk factor based on epidemiological studies; however, few researches have focused on its effect on coronary atherosclerotic plaque progression. METHODS: From June 7, 2007 to December 30, 2011, 366 patients received their index coronary angiogram and were subsequently found to have coronary atherosclerotic plaques or normal angiograms were consecutively enrolled in the study by the department of cardiology at the Ruijin Hospital, which is affiliated to the Shanghai Jiaotong University School of Medicine. All patients had follow-up angiograms after the 1-year period for evaluating the progression of the coronary lesions. The modified Gensini score was adopted for assessing coronary lesions while the HOMA-IR method was utilized for determining the state of their insulin resistance. Baseline characteristics and laboratory test results were described and the binomial regression analysis was conducted to investigate the relationship between insulin resistance and coronary atherosclerotic plaque progression. RESULTS: Index and follow-up Gensini scores were similar between the higher insulin lower insulin resistant groups (9.09 ± 14.33 vs 9.44 ± 12.88, p = 0.813 and 17.21 ± 18.46 vs 14.09 ± 14.18, p =0.358). However the Gensini score assessing coronary lesion progression between both visits was significantly elevated in the higher insulin resistant group (8.13 ± 11.83 versus 4.65 ± 7.58, p = 0.019). Multivariate logistic binomial regression analysis revealed that insulin resistance (HOMA-IR > 3.4583) was an independent predictor for coronary arterial plaque progression (OR = 4.969, p = 0.011). We also divided all the participants into a diabetic (n = 136) and a non-diabetic group (n = 230), and HOMA-IR remained an independent predictor for atherosclerosis plaque progression. CONCLUSIONS: Insulin resistance is an independent predictor of atherosclerosis plaque progression in patients with coronary heart disease in both the diabetic and non-diabetic population

The 11-Year Prognostic Impact of Chronic Total Occlusion in the Noninfarct-Related Coronary Artery on Patients with Acute Myocardial Infarction

Background. The prognostic significance of CTO in the non-IRA in patients with AMI has been under dispute. Relevant long-term follow-up studies are lacking. Hypothesis. CTO in the non-IRA is an independent predictor of poor long-term prognosis in patients with AMI. Methods. We prospectively enrolled 2336 patients with AMI who received emergent percutaneous coronary intervention successfully from January 2006 to May 2011. Our primary endpoints included death from cardiovascular causes, recurrent myocardial infarction, stroke, and target-vessel revascularization. We adopted Cox regression analysis adjusted for confounders to analyze the impact of CTO in the non-IRA on long-term mortalities. Results. We identified 628 (27.6%) subjects with CTO in the non-IRA among 2282 AMI patients. After a mean follow-up duration of 134.3 months, we found the CTO group had significantly higher MACCE rate than the group without CTO (30.4% versus 24.3%, P=0.004). CTO in the non-IRA independently predicted 11-year MACCE in the male AMI subgroup (hazard ratio 1.28, 95% confidence interval 1.06 to 1.54, P=0.01) and in the male NSTEMI subgroup (hazard ratio 1.53, 95% confidence interval 1.09 to 2.15, P=0.02). In the CTO group, three-vessel disease independently predicted 11 year MACCE (hazard ratio 2.05, 95% confidence interval 1.29 to 3.28, P=0.002). Conclusions. Our long-term observational study supported the association between CTO in the non-IRA and poorer prognosis in AMI patients undergoing primary PCI. We identified the group with the three-vessel disease as a high-risk subgroup in patients with CTO in the non-IRA

A Range and Azimuth Combined Two-dimensional NCS Algorithm for Spaceborne-missile Bistatic Forward-looking SAR

The spaceborne-missile bistatic forward-looking Synthetic Aperture Radar (SAR) is a promising imaging guidance technology that can obtain high-resolution images of the area in front of the missile all day and in all weather types. However, the coupling and spatial variations in range and azimuth parameters hinder the development of high-resolution spaceborne-missile bistatic forward-looking SAR imaging. In this study, the accurate-range Doppler domain analytical formula for echo signals was derived based on the low-orbit spaceborne illuminator and high-speed forward-looking missile-borne receiving platform configuration. Subsequently, in range processing, a range Nonlinear Chirp Scaling (NCS) was proposed to equalize the range cell migration and range Frequency Modulation (FM) rate, and both can be uniformly compensated in the two-dimensional frequency domain. In azimuth processing, the proposed method decomposed the azimuth FM rates of the transmitter and receiver. Then, the azimuth NCS was used to eliminate the high-order spatial variation of the azimuth FM rate. Finally, a two-dimensional matched filtering was performed to obtain a SAR image with a good global focus. The point and scene simulation verify the effectiveness of the proposed algorithm

Mechanical properties of a new fully prefabricated staggered flip-down slab

Prefabricated slab has been widely used in the global construction industry due to energy saving, environmental protection, and good economic advantages. In this paper, a new type of fully prefabricated staggered flip-down slab without cast-in-situ operation has been proposed. First, the experiments were carried out on the new slab. The structural performance of the new slab was compared with the cast-in-situ slabs and composite slabs of the same specification. The experimental results showed that the ultimate bearing capacity of the new slab meets the requirements for practical utilization. On this basis, an additional CFRP sheet could be pasted on the bottom initial seam between prefabricated slabs to enhance the integrity and prevent cracks. Then, the whole loading process of the slab was simulated, and the results were consistent with the experimental results. Finally, through experiments and parametric analysis, recommendations for improvement were put forward to enhance the mechanical properties of this kind of slab