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Background MicroRNA (miRNA) expression profiles in endothelial progenitor cells (EPCs) contribute to EPC dysfunction in patients suffering from coronary artery disease. However, it remains unclear whether miRNA expression in EPCs is associated with the prognosis of chronic heart failure (CHF) secondary to ischemic cardiomyopathy (ICM) or non-ischemic cardiomyopathy (NICM). Methods and results One hundred six patients with CHF (55 ICM and 51 NICM) and 30 healthy controls were followed until the end of 24months or when the end point was obtained (cardiovascular death). The miRNA expression profile was analyzed by TaqMan Human MicroRNA Array Set v2.0 in 30 randomly assigned samples (ICM=10, NICM=10, and healthy controls=10). During the 24-month follow-up, 26 patients died from cardiovascular disease. Sixteen miRNAs (miR-126, miR-508-5p, miR-34a, miR-210, miR-490-3p, miR-513-5p, miR-517c, miR-518e, miR-589, miR-220c, miR-200a*, miR-186*, miR-7i*, miR-200b*, miR-595, and miR-662) were found to be differentially expressed between ICM and NICM patients. Survival analysis showed that miR-126 and miR-508-5p levels in EPCs were independent prognostic factors ( P =0.003; HR (hazard ratio): 0.19; 95% CI (confidence intervals): 0.06–0.58, P =0.002; HR: 2.292; 95% CI: 1.37–3.84) for the outcome of ICM or NICM patients with CHF. Pathway enrichment analysis showed that the angiogenesis pathway was the most likely pathway regulated by miR-126 and miR-508-5p. Conclusions The miRNAs miR-126 and miR-508-5p are associated with the outcome of ICM and NICM patients with CHF. These two miRNAs could be useful in the diagnosis of CHF patients, and might provide novel targets for prevention and treatment of CHF.

To evaluate the prognostic value of N-terminal prohormone B-type natriuretic peptide (NT-proBNP) for patients with stable coronary artery disease, we searched for all published English-language articles indexed in MEDLINE and PubMed through July 2011. Nine independent, prospective, cohort studies that assessed the association between NT-proBNP value and long-term prognosis were identified. The interested endpoints of this meta-analysis were all-cause mortality and cardiovascular mortality and cardiovascular events. A general variance-based method was used to pool the hazard ratio (HR). In a comparison of individuals in the top quartile with those in the bottom quartile of baseline values of NT-proBNP, the combined adjusted HR was 2.74 (95% confidence interval [CI], 1.85-3.62). The combined HRs for the second and third quartiles compared with the first quartile were 1.33 (95% CI, 0.83-1.82) and 1.85 (95% CI, 1.23-2.48), respectively. In a subanalysis grouped by the median value, per 1 standard deviation increase or per 1000 pg/mL increase of NT-proBNP, the overall effect also showed that poor prognosis was significantly increased with the elevation of NT-proBNP (HR, 1.58; 95% CI, 1.16-2.01). Available prospective studies indicated strong associations between the circulating concentration of NT-proBNP and long-term prognosis in patients with stable coronary artery disease.

Objectives: To evaluate the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP) values and the severity of coronary lesions at angiography in unstable angina patients with preserved left ventricular function. Methods: A total of 133 patients with primary diagnosis of unstable angina were enrolled into this study. NT-proBNP level was determined before the angiography and Gensini score, a measurement of extent of myocardial ischemia, was calculated after the angiography by experienced cardiologists. Patients with >50% stenosis of the left main or 75% stenosis of one or more coronary branches with diameter >2 mm were defined as “angiography positive” and turned to percutaneous coronary intervention. Results: There was a significant difference of circulating NT-proBNP level between the angiography positive and negative groups and the median NT-proBNP values were 367.5 pg/mL and 112 pg/mL, respectively (P < 0.001). A significant correlation was observed between log NT-proBNP and log Gensini score (P < 0.001). NT-proBNP level was a predictor of angiography positive result and the area under the receiver operating characteristic curve was 0.776 (95% CI 0.693–0.858). Conclusions: NT-proBNP level was found to be higher with the severity of myocardial ischemia. However, the ability of NT-proBNP to identify clinically significant angiographic lesions was moderate. (J Interven Cardiol 2012;25:126–131)

Objectives To compare the clinical outcomes after placement of zotarolimus-eluting stent (ZES) and the first generation stents (sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES)) in patients with coronary artery disease. Methods Six eligible randomised trials with nine publications were identified. The primary end point was major adverse cardiac events (MACE) and secondary end points were all-cause death, cardiac death and myocardial infarction (MI). Events occurred within 1 year were defined as late clinical outcomes and those after 1 year were defined as very late clinical outcomes. Results Overall relative risk (RR) and 95% CI were calculated for ZES versus SES and PES for each of the end points. No heterogeneity across the trials was observed. The risk of MACE (late period RR 1.41; 95% CI 1.17 to 1.71; very late period RR 1.33; 95% CI 1.09 to 1.61) was increased by use of ZES compared with SES and no significant difference in the risk of all-cause death, cardiac death and MI was found. Pooled analysis also demonstrated statistically significant reduction of ZES compared with PES in MI (late period RR 0.71; 95% CI 0.54 to 0.94; very late period RR 0.48; 95% CI 0.32 to 0.73) and no significant difference in the risk of MACE, all-cause death and cardiac death. Conclusions Available data suggested that he ZES was inferior to SES in terms of MACE and superior to PES in terms of MI. Future studies with more participants and longer follow-up are needed to better clarify the relative merits of these drug-eluting stents.

Objective The new biochemical indicator ischaemia modified albumin (IMA) cmay reflect the degree of myocardial ischaemia sensitively. We studied the variation of ischaemia as assessed by the change in level of IMA during the transient myocardial ischaemia due to balloon dilation during PCI. Methods Thirty one patients who were ready to undergo PCI were randomly selected. The IMA was detected with ACB (albumin cobalt binding) test before and after saccule dilation. To study if the IMA level after saccule dilation was high than before, and if the change had statistical significance, we used Paired-Sample T test in the SPSS statistics software. Results The data was signed by means of (mean±SD), the IMA level before saccule dilation was (77.03±13.82) U/ml and after was (90.06±23.58) U/ml. To analyse the data, we found the IMA level after dilation was higher than that before, and the difference had statistical significance (p=0.011, obviously Conclusion Balloon dilation was an ideal model of transient myocardial ischaemia which can be reflected by the change of the IMA level. We were able to cofirm the value of IMA as a new biochemical indicator on the detection of myocardial ischaemia during balloon dilation.

Objective Saccule predilation has been an essential device during percutaneous coronary intervention (PCI). We evaluate the ischaemic preconditioning effect of repeated myocardial ischaemia during predilations. Methods Thirty one patients who were ready to undergoing PCI were randomly selected. And we choosed the new biochemical indicator ischaemia modified albumin (IMA) as a sensitive index, and the IMA were detected with ACB (albumin cobalt binding) test before saccule dilations, after dilations and after stent implantation. To analyse the data, we used Paired-Sample T test in the SPSS statistics software to investigate the change of the IMA level, and if the change had statistical significance. Results The data was signed by means of (mean±SD), the IMA level were (77.03±13.82) U/ml, (90.06±23.58) U/ml and (82.43±21.87) U/ml before saccule predilation, after predilations and after stent implantation. We found the IMA level was lower after stent implantation than that after saccule predilations, and the variance had statistical significance (p=0.031, 0.05). Conclusion The degree of myocardial ischaemia was relieved during saccule predilations, even can neutralise the ischaemic effect that dilations causing. We can suppose the intrinsic mechanism which we called ischaemic preconditioning effect that pretected the myocardium.

Objective To study the effect on the management of patients suffering from coronary atherosclerotic heart disease combined with chronic heart failure. Method 1109 patients who discharged from our department were enrolled randomly. These patients were ranked as the manage group and control group. Patients in manage group accepted standardised management out of hospital, regular health education, and were followed up in the form of telephone and outpatient visit. Result Compared with the control group, the manage group showed the lower rate of all cause of death, cardiac death and readmission due to cardiovascular events (CVE), declined by 32.0%, 36.5% and 58.4% respectively. All cause of death, cardiac death and readmission due to CVE in manage group had significantly negative correlation with the years of death. But there was no ascendency in reducing the rate of stroke and myocardial infarction. Conclusion Through standardised management out of hospital, patients who were suffering from coronary atherosclerotic heart disease combined with chronic heart failure got significant benefit in reducing the rate of all cause of death, cardiac death and readmission due to CVE, and survival rate of patients was improved.