Background: In-stent restenosis (ISR) remains a major drawback in coronary stenting. The association between the CYP2C19 loss of function (LOF) gene and the prevalence of ISR after coronary stenting remains controversial. Previous studies have produced conflicting results and have been limited by their small population sizes. We conducted this systematic review and meta-analysis to determine the association between the presence of the CYP2C19 LOF gene and the prevalence of ISR. Methods: A systematic online database search was performed until April 2021. The primary outcome was ISR and assessed using OR with 95% CI. Publication bias was assessed using the Newcastle Ottawa Scale. I2 was applied to examine heterogeneities among the studies. Results: A total of 284 patients (four non-randomized controlled trial studies) were included in this study. Two hundred and six patients had wild-type genotypes, while 78 patients had the LOF genotype. Among the 78 patients with the LOF gene, 40 patients had an ISR. Meanwhile, of the 206 patients with a wild-type gene, 69 patients had an ISR. The LOF gene was associated with a higher risk of ISR (OR 95% CI = 2.84 [1.54–5.24], p = 0.0008). A major limitation in our study was the small number of previous studies and small sample sizes. Conclusions: Patients with LOF genes, regardless of the allele variation, treated with clopidogrel, had a higher risk of developing ISR after coronary stenting.
A Review of CRISPR Cas9 for Alzheimer’s Disease: Treatment Strategies and Could target APOE e4, APP, and PSEN-1 Gene using CRISPR cas9 Prevent the Patient from Alzheimer’s Disease? BACKGROUND: Alzheimer’s disease is a neurodegenerative disorder characterized by the formation of β-amyloid plaques and neurofibrillary tangles from hyperphosphorylated tau. Several studies suggest that targeting the deletion of the APOE e4, PSEN-1, and APP will reduce tau phosphorylation and Aβ protein accumulation, a crucial hypothesis for the causation of Alzheimer’s disease. APOE e4, PSEN-1, and APP with genome editing Clustered Regular interspersed Short Palindromic Repeats-CRISPR-related (CRISPR/Cas9) are thought to have therapeutic promise for Alzheimer’s disease.AIM: The purpose of this study was to determine whether targeting APOE e4, PSEN-1, and APP using CRISPR/Cas9 is an effective therapeutic and whether it has a long-term effect on Alzheimer’s disease.METHODS: The method used in this study summarized articles by examining the titles and abstracts of specific specified keywords. In this situation, the author picked the title and abstract that matched PubMed, Google Scholar, Science Direct, Cochrane, and the Frontiers in Neuroscience; this was followed by checking to see whether the paper was available in full-text. Eventually, the researcher will study the entire article to decide if it is valuable and relevant to the issue.RESULTS: CRISPR/Cas9 deletion of APOE e4, PSEN-1, and APP in induced pluripotent stem cells (iPSC’s) and g2576 mice as APP mutant models reduce tau phosphorylation and Aβ protein accumulation from neurofibrillary tangles and prevent cell death, vascular damage, and dementia. Furthermore, CRISPR/Cas9 deletion in APOE e4, PSEN-1, and APP improved neuronal cell resilience to oxidative stress and inflammation.CONCLUSION: APOE e4, PSEN-1, and APP deletion by genome editing CRISPR/Cas9 is effective to reduce tau phosphorylation and Aβ protein accumulation from neurofibrillary tangles, cell death, vascular damage, and dementia. However, further research is needed to determine the side effects and safety of its use.
Introduction: The Systemic Immune-inflammation Index (SII) is a simple, non-invasive, and low-cost parameter that has been studied to predict ulcerative colitis (UC). However, the result remains inconclusive. Therefore, this study aimed to confirm the utilization of SII in UC. Methods: A systematic search was conducted. The inclusion criteria were articles that investigated the relationship between SII and UC and reported a specific cut-off value, specific sensitivity, specificity, and area under the curve (AUC). The odds ratio (OR) and mean difference (MD) using a 95 % confidence interval (CI) were used.
Aims SGLT-2 Inhibitor is an anti-diabetic drug. SGLT-2 Inhibitor has favourably effect in cardiovascular outcomes. However, the three-year cardiovascular outcomes of SGLT-2 Inhibitor in Type-2 Diabetes Mellitus remains unclear. We performed meta-analysis to evaluate cardiovascular outcomes in three-years of SGLT-2 Inhibitor therapy. Methods We performed a systematic literature search from various electronic databases. We used keywords “SGLT-2 Inhibitor”, “Type-2 Diabetes Mellitus”, and “Cardiovascular outcome”. Inclusion criteria for research is Randomized Control Trial and 3-year follow-up. Primary endpoint is Major Adverse Cardiovascular Event (MACE). Secondary endpoints are all-cause mortality, cardiovascular mortality and hospitalization of heart failure. Risk ratio (RR) with 95% confidence interval were used to report all outcomes. Results Total of two Randomized Control Trial was selected (EMPA-REG [Jardiance®] and VERTIS-CV [Steglatro®] trial) with 15.266 patients pooled in our analysis. Results of three-year primary outcome compared SGLT-2 Inhibitor with Placebo had no significant reduction in MACE (RR = 0.93 [95% CI, 0.81–1.07], p = 0.32; I2=56%). Result of secondary outcome showed no significant reduction in all-cause mortality (RR = 0.80 [95% CI, 0.60-1.08], p = 0.15; I2=85%) and cardiovascular mortality (RR = 0.77 [95% CI, 0.52–1.12], p = 0.17; I2=87%). However, there are significant reduction in hospitalization of heart failure (RR = 0.68 [95% CI, 0.57–0.82], p < 0.00001; I2=0%). Conclusion SGLT-2 Inhibitor in Type-2 Diabetes Mellitus has significant reduction in hospitalization of heart failure. However, no significant results were found in MACE, all-cause mortality, and cardiovascular mortality after 3-year follow-up.
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