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To the Editor: In recent years, the introduction (1) of drugeluting stents (DES) during percutaneous coronary interventions (PCI) has been one of the major breakthroughs in interventional procedures. Several observational and randomized studies have shown a significantly lower restenosis rate with DES compared with bare-stent technology. Sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES) stents also substantially reduce the need for repeat revascularization procedures compared with standard stent technology (2-5). However, late safety outcome of these new devices is not well established. Late stent thrombosis, not seen in the first series of studies (1-5), has been recently reported (6,7) and was associated with major adverse cardiac events. Even though a meta-analysis of randomized studies and registries confirmed the efficacy and safety of DES (8), these studies were not powered to detect any increase in late-stent thrombosis. Furthermore, in those studies, stent thrombosis (SET) was not equal and appropriately defined; more importantly, none of the cited studies included SET as a prespecified end point. Therefore, we sought to investigate the incidence of SET in a DES population (9) included prospectively in the multicenter and controlled Argentine Randomized Trial of Coronary Stents versus Bypass Surgery (ERACI III) trial.From June 2002 to December 2004, 225 patients treated with PCI and DES in five centers in Buenos Aires meeting the clinical and angiographic criteria of the ERACI II trial (10) were prospectively and consecutively included in the ERACI III study. The inclusion criteria of the ERACI studies were previously reported (10). All patients had multiple-vessel disease and were treated with at least one DES, SES, or PES in equal proportion (Cypher, Cordis, Johnson and Johnson, Miami Lakes, Florida; and TAXUS, Boston Scientific Corp., Natick, Massachusetts). The end points of the ERACI III study were to compare major and minor cardiac adverse events at one, two, three, and five years of follow-up between the ERACI III DES patients (n ϭ 225) and ERACI II PCI (n ϭ 225) and ERACI II CABG study patients (n ϭ 225). Comparison of coronary stent thrombosis (SET) between the ERACI III and ERACI II PCI study arm (bare stent) was one of the secondary end points of this study. The purpose of this study was to analyze the incidence of SET during the first 30 days and during follow-up in the ERACI III study patients.Stent thrombosis was defined as follows: 42 LM ϭ left main coronary artery.

Galectin-1 (Gal-1), an evolutionarily conserved β-galactoside-binding lectin, controls immune cell homeostasis and tempers acute and chronic inflammation by blunting proinflammatory cytokine synthesis, engaging T-cell apoptotic programs, promoting expansion of T regulatory (Treg) cells, and deactivating antigen-presenting cells. In addition, this lectin promotes angiogenesis by co-opting the vascular endothelial growth factor receptor (VEGFR) 2 signaling pathway. Since a coordinated network of immunomodulatory and proangiogenic mediators controls cardiac homeostasis, this lectin has been proposed to play a key hierarchical role in cardiac pathophysiology via glycan-dependent regulation of inflammatory responses. Here, we discuss the emerging roles of Gal-1 in cardiovascular diseases including acute myocardial infarction, heart failure, Chagas cardiomyopathy, pulmonary hypertension, and ischemic stroke, highlighting underlying anti-inflammatory mechanisms and therapeutic opportunities. Whereas Gal-1 administration emerges as a potential novel treatment option in acute myocardial infarction and ischemic stroke, Gal-1 blockade may contribute to attenuate pulmonary arterial hypertension.

AimsThe aim of this study was to evaluate whether neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) predict outcome in heart failure (HF) patients undergoing heart transplantation (HTX).Methods and resultsData from 111 HF patients undergoing HTX 2010–2015 were retrospectively reviewed. NLR and PLR were calculated before HTX, immediately after HTX, and at 6 and 24 hours. Primary endpoint was in‐hospital mortality, and secondary endpoints were 1 year mortality and renal replacement therapy (RRT). Prognostic factors were assessed by multivariate analysis, and the predictive values of NLR and PLR for mortality were compared. The discriminatory performance for predicting in‐hospital mortality was better for NLR [area under the receiver operating characteristic curve (AUC) = 0.644, 95% confidence interval 0.492–0.797] than for PLR (AUC = 0.599, 95% confidence interval 0.423–0.776). Best cut‐off value was 2.41 for NLR (sensitivity 86%, specificity 67%) and 92.5 for PLR (sensitivity 86%, specificity 68%). When divided according to best cut‐off value, in‐hospital mortality was significantly higher in the high NLR group (17.5% vs. 3.2%, P < 0.05), but not in the high PLR group (16.5% vs. 6.3%, P = ns). One year mortality was not significantly higher for either group (37.5% vs. 6.5% for NLR; 36.7% vs. 9.4% for PLR, P = ns for both), while RRT was significantly higher in both the NLR and PLR high groups (33.8% vs. 0%; 32.9% vs. 3.1%, respectively, P < 0.001). Multivariate analysis indicated that only high NLR (hazard ratio = 3.403, P < 0.05) and pre‐transplant diabetes (hazard ratio = 3.364, P < 0.05) were independent prognostic factors for 1 year mortality.ConclusionsHigh NLR was a predictor for in‐hospital mortality, and an independent prognostic factor for 1 year mortality. Both high NLR and high PLR were predictors for RRT.

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