Cheung, BMY

Li, YY

Tang, F

Hong Kong Medical Journal

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Title Endotoxin increases adrenomedullin expression in heart, lungand mesenteric arteryAuthor(s) Li, YY; Tang, F; Cheung, BMYCitationThe 8th Medical Research Conference Abstracts, Hong KongMedical Journal, Hong Kong, China, 25-26 January 2003, v. 9 n. 1Supp 1, p. 30Issued Date 2003URL http://hdl.handle.net/10722/46923Rights Creative Commons: Attribution 3.0 Hong Kong License30      HKMJ Vol 9 No 1 February 2003 SupplementThe Heart Protection Study findings with simvastatin reanalysed by numberneeded to treatCR Kumana, BMY Cheung & IJ Lauder.† Departments of Medicine and Statistics & Actuarial Science,† The University ofHong Kong, Queen Mary Hospital, Hong KongIntroduction: Number Needed toTreat (NNT) is superior to Relative Risk Reduction (RRR) as a means of assessing clinical trial results. We therefore opted tocompare relevant RRRs and NNTs in the MRC/BHF Heart Protection Study(HPS) with Simvastatin the largest randomized trial of coronary heart disease (CHD)prevention to date, which recruited patients with prior CHD, diabetes or hypertension [HPS Collaborative Group 2002 Lancet 360:7-22].Methods: Using an Excel spreadsheet to enter event rates, NNTs and respective 95% CIs were calculated and compared with corresponding published (or derived)RRRs.Results: Respective event rates, 5 year NNTs & CIs are shown in the table.Conclusions: NNTs are more discriminating than RRRs. They confirm that the benefits of statins: are clinically significant in terms of all-cause mortality and stroke,and that for major vascular events they are similar in persons with CHD only or diabetes only and in all cholesterol level and age categories.Outcome of Interest Event Rate (%) %RRR NNTSimvastatin Placebo (95% CIs) (95% CIs)All Cause Mortality 12.9 14.7 12 (5 to 18.) 57 (37 to 128)Vascular Mortality 7.6 9.1 17 (8 to 24) 66 (44 to 134)Non-vascular Mortality 5.3 5.6 4 (* to 15) 444 (* to 117)1st Major CHD Event 8.7 11.8 26 (19 to 32) 32.7 (26 to 45)1st Stroke 4.3 5.7 24 (14 to 33) 73 (50 to 131)Revascularisaton 9.1 11.7 22 (15 to 29) 39 (29 to 58)1st Major Vascular Event<5.0 17.7 23.1 23 (12 to 33) 19 (13 to 35)Total Cholesterol (mmol/L) ≥5.0 <6.0 16.9 24.5 23 (15 to 30) 18 (13 to 27)≥6.0 21.6 26.8 19 (12 to 26) 19 (14 to 30)<65 16.9 22.1 23 (16 to 30) 19 (15 to 28)Age   (years) ≥65 <70 20.9 27.2 23 (14 to 32) 16 (11 to 26)≥70 23.6 28.7 18 (9 to 26) 20 (14 to 36)Prior CHD only 16.8 22.5 25 (17 to 33) 18 (13 to 26)Prior Diabetes only 13.8 18.6 26 (13 to 37) 21 (14 to 40)Prior CHD + Diabetes 33.4 37.8 11 (* to 24) 23 (12 to *)* Denotes a negative value indicating an increased event rate in the treated group, renderng further analysis inappropriate; 1st major coronary event = non-fatal MIor CHD death; Revascularisation = coronary and non-coronary bypass and angioplasty; 1st major vascular event = 1st major coronary event, stroke or revascularisationCVS-23CVS-24 Endotoxin increases adrenomedullin expression in heart, lung and mesentericarteryYY Li, F Tang1 and BMY Cheung2Department of Physiology1 and Department of Medicine,2 The University of Hong KongIntroduction: Previous studies have shown that the circulating levels of adrenomedullin (AM) are elevated duringinflammation. The levels of AM and its messenger RNA (mRNA) in various tissues during the time course ofinflammation remain to be determined.Method: Inflammation was induced in rats by intraperitoneal injection of lipopolysaccharide (LPS, 10mg/kg). Thetissues were harvested at 0, 1, 3 and 6 hours after LPS administration. Tissue levels of AM were determinedby radioimmunoassay. The gene expression levels of AM were determined by solution hybridization-RNaseprotection assay of preproAM mRNA levels.Results: PreproAM mRNA levels were increased in mesenteric artery and right atrium at 1 hour, in the leftventricle and the lung at 3 and 6 hours and in the right ventricle at 6 hours, after LPS injection. AM levels in themesenteric artery were increased at 1, 3 and 6 hours and at 3 and 6 hours in the lung after LPS injection.Conclusions: There is an increase in AM release in the lung, so it may be an important organ for AM secretion inthe septic state. However, the response of the lung and the mesenteric artery to LPS in terms of AM secretionappears to be different.

Endotoxin increases adrenomedullin expression in heart, lung and mesenteric artery

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Endotoxin increases adrenomedullin expression in heart, lung and mesenteric artery

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