Circulation journal : official journal of the Japanese Circulation Society
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Randomized Controlled Trial Comparative Study
Myocardial protective effect of human atrial natriuretic Peptide in cardiac surgery. -hANP Shot” in clinical safety trial-.
We studied low-dose human atrial natriuretic peptide (hANP) infusion therapy during cardiac surgery and reported the cardiac and renal protective effects. The efficacy of a bolus injection of hANP (the "hANP shot") simultaneously with induction of cardioplegia has been proven in animal experiments. In the present study the clinical effects of this "hANP shot" were examined. ⋯ It is possible to achieve cardioprotective effects based on the safety of the "hANP shot", as well as from biomarkers of ischemia and results related to arrhythmia. The "hANP shot" should also be evaluated as a safer and new cardioprotective method for cardiac surgery.
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Comparative Study Clinical Trial
Soluble lectin-like oxidized LDL receptor-1 and high-sensitivity troponin T as diagnostic biomarkers for acute coronary syndrome. Improved values with combination usage in emergency rooms.
Although highly sensitive assays for troponin T (hs-TnT) have been developed, the sensitivity and specificity of hs-TnT for diagnosing acute coronary syndrome (ACS) remains imperfect. We evaluated the diagnostic value of a new biomarker of plaque vulnerability (soluble lectin-like oxidized low-density lipoprotein receptor-1, sLOX-1) as compared with hs-TnT in the emergency room (ER). ⋯ The diagnostic value for ACS was comparable between sLOX-1 and hs-TnT, and the accuracy of ACS diagnosis appeared to improve when sLOX-1 and hs-TnT were measured in combination.
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There is conflicting data regarding the impact of obesity on morbidity and mortality in patients undergoing isolated coronary artery bypass grafting (CABG). ⋯ Obesity was associated with an increased risk of postoperative respiratory failure, postoperative renal failure, and surgical site infections. However, obesity was not associated with in-hospital mortality in patients undergoing CABG.
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Comparative Study
The impact of hyperuricemia on in-hospital mortality and incidence of acute kidney injury in patients undergoing percutaneous coronary intervention.
There is very little information about the relationship between hyperuricemia, acute kidney injury (AKI) and in-hospital mortality. ⋯ It is clear that AKI develops due to multiple risk factors. Our results indicate that hyperuricemia is independently associated with an increased risk of in-hospital mortality and AKI in patients treated with PCI.
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Comparative Study
Long-term patency rate for radial artery vs. saphenous vein grafts using same-patient materials.
The aim of the present study was to assess the long-term graft patency rate of the radial artery (RA), in comparison to the saphenous vein (SV) in patients harvested for both vessels. ⋯ Cumulative graft patency rates between RA and SV were similar at 8 years. RA performed more poorly in patients with target vessel stenosis <75% and in those complicated by PVD. Aggressive anti-platelet therapy and strict lipid control may be important in maintaining long-term patency of SV.