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Summary: Background: The prognosis of patients with coronary artery disease (CAD) at hospital discharge was constantly varying, and postdischarge risk of ischemic events remain a concern. However, risk prediction tools to identify risk of ischemia for these patients has not yet been reported. Aims: We sought to develop a scoring system for predicting long‐term ischemic events in CAD patients receiving antiplatelet therapy that would be beneficial in appropriate personalized decision‐making for these patients. Methods: In this prospective Optimal antiPlatelet Therapy for Chinese patients with Coronary Artery Disease (OPT‐CAD, NCT01735305) registry, a total of 14 032 patients with CAD receiving at least one kind of antiplatelet agent were enrolled from 107 centers across China, from January 2012 to March 2014. The risk scoring system was developed in a derivation cohort (enrolled initially 10 000 patients in the database) using a logistic regression model and was subsequently tested in a validation cohort (the last 4032 patients). Points in risk score were assigned based on the multivariable odds ratio of each factor. Ischemic events were defined as the composite of cardiac death, myocardial infarction or stroke. Results: Ischemic events occurred in 342 (3.4%) patients in the derivation cohort and 160 (4.0%) patients in the validation cohort during 1‐year follow‐up. The OPT‐CAD score, ranging from 0‐257 points, consist of 10 independent risk factors, including age (0‐71 points), heart rates (0‐36 points), hypertension (0‐20 points), prior myocardial infarction (16 points), prior stroke (16 points), renal insufficient (21 points), anemia (19 points), low ejection fraction (22 points), positive cardiac troponin (23 points) and ST‐segment deviation (13 points). In predicting 1‐year ischemic events, the area under receiver operating characteristics curve were 0.73 and 0.72 in derivation and validation cohort, respectively. The incidences of ischemic events in low‐ (0‐90 points), medium‐ (91‐150 points) and high‐risk (≥151 points) patients were 1.6%, 5.5%, and 15.0%, respectively. Compared to GRACE score, OPT‐CAD score had a better discrimination in predicting ischemic events and all‐cause mortality (ischemic events: 0.72 vs 0.65, all‐cause mortality: 0.79 vs 0.72, both P < .001). Conclusions: Among CAD patients, a risk score based on 10 baseline clinical variables performed better than the GRACE risk score in predicting long‐term ischemic events. However, further research is needed to assess the value of the OPT‐CAD score in guiding the management of antiplatelet therapy for patients with CAD. [ABSTRACT FROM AUTHOR]

Genetic polymorphisms in cytotoxic T lymphocyte-associated antigen 4 (CTLA4) play an influential role in graft rejection and the long-term clinical outcome of organ transplantation. We investigated the association of five CTLA4 single-nucleotide polymorphisms (SNPs) (rs733618 C/T, rs4553808 A/G, rs5742909 C/T, rs231775 A/G, and rs3087243 G/A) with de novo malignancy in 1463 Chinese renal transplantation (RT) recipients who underwent a 192-month follow-up. Multivariate analyses revealed that recipient rs231775 genotype is significantly associated with tumorigenesis (P=0.012). Multiplicative interaction between rs231775 AA and possible risk factors of malignancy revealed two significant results: rs231775 AA × primary diseases and rs231775 AA × number of HLA-mismatch. The frequency of haplotype TACAG was significantly higher in the tumor group (17.07%) than that in the nontumor group (1.53%). In addition, aristolochic acid nephropathy (P=0.003) and the time of discovery of tumor (P=0.000) also were independently associated with tumorigenesis. Our data show that the CTLA4 genotype rs231775 AA may be one of risk factors for the development of malignancy and haplotype TACAG was susceptible haplotype in Chinese kidney transplant recipients. [ABSTRACT FROM AUTHOR]

Background Sirolimus-eluting stents (SES) with a biodegradable polymer coating have demonstrated promising results but have not been compared to SES with a durable polymer in high-risk patients. We compared the efficacy of these 2 stent types in patients with acute myocardial infarction (STEMI). Methods One thousand one hundred ninety-two STEMI patients were randomized to receive SES coated with biodegradable (n = 596) or durable polymer (n = 596). The study end-point was the composite of major adverse cardiac events (MACE) including all-cause death, recurrent myocardial infarction (MI), or target lesion revascularization (TLR) at 1-year follow-up. Secondary end-points included individual components of primary end-point and stent thrombosis. Results Compared with durable polymer SES, the noninferiority of SES with biodegradable polymer coating was established by an absolute risk difference of 0.9% in the primary end-point (12.4% vs. 13.3%, P = 0.67) and an upper limit of one-sided 95% confidence interval (CI) of 2.96% (P for noninferiority = 0.001). Rate of death, recurrent MI, and TLR were 7.9% and 8.6% (HR: 0.92; 95% CI: 0.61-1.38, P = 0.67), 2.9% and 3.5% (HR: 0.80; 95% CI: 0.42-1.54, P = 0.51), and 2.0% and 3.2% (HR: 0.62; 95% CI: 0.30-1.30, P = 0.20) in the biodegradable polymer SES and durable polymer SES group at 1-year clinical follow-up, respectively. Despite similar rates of 30-day ARC definite/probable stent thrombosis, late stent thrombosis (stent thrombosis occurring beyond 30 days) was lower with biodegradable polymer SES (0.7% vs. 2.2%, P = 0.028). Conclusions In patients undergoing primary PCI for STEMI, the use of biodegradable polymer SES was associated with noninferior 1-year rates of MACE compared with durable polymer SES. (J Interven Cardiol 2014;27:131-141) [ABSTRACT FROM AUTHOR]

The purpose of this paper is to introduce a transmission power control scheme based on the remaining energy level and the energy-harvesting status of individual sensor nodes to extend the overall lifetime of wireless sensor networks (WSNs) and balance the energy usage. Ambient energy harvesting has been introduced as a promising technique to solve the energy constraint problem of WSNs. However, considering the tiny equipment and the inherent low and unbalanced harvesting capability due to environmental issues, there is still a long distance from perfectly solving the problem. In this paper, a wind and solar power joint-harvested WSN system has been demonstrated, which uses ultracapacitor as energy storage. By analyzing the power recharging, leakage, and energy consumption rate, a novel energy-level-based transmission power control scheme (EL-TPC) is produced. In EL-TPC scheme, the transmission power is classified into various levels according to the remaining energy level. By adapting the nodes' operation pattern, hierarchical network architecture can be formed, which prioritizes the use of high energy level, fast charging nodes to save the energy of uncharged nodes. The simulation and demonstration results show that EL-TPC scheme can significantly balance the energy consumption and extend the entire network lifetime. [ABSTRACT FROM AUTHOR]