With the methods used, we found no effects of intracoronary injection of autologous mononuclear BMC on global left ventricular function.

Stent implantation improved long-term angiographic and clinical results after PTCA of chronic coronary occlusions and is thus recommended regardless of the primary PTCA result.

Abstract-We aimed to investigate for the first time the blood pressure (BP)-lowering effect of renal sympathetic denervation (RDN) versus clinically adjusted drug treatment in true treatment-resistant hypertension (TRH) after excluding patients with confounding poor drug adherence. Patients with apparent TRH (n=65) were referred for RDN, and those with secondary and spurious hypertension (n=26) were excluded. TRH was defined as office systolic BP (SBP) >140 mm Hg, despite maximally tolerated doses of ≥3 antihypertensive drugs including a diuretic. In addition, ambulatory daytime SBP >135 mm Hg after witnessed intake of antihypertensive drugs was required, after which 20 patients had normalized BP and were excluded. Patients with true TRH were randomized and underwent RDN (n=9) performed with Symplicity Catheter System versus clinically adjusted drug treatment (n=10

Type 1 diabetic patients have a pronounced risk of premature coronary artery disease and death. We sought to evaluate the prevalence of silent coronary atheromatosis and to evaluate the relation between coronary atheromatosis and glycemic control. Coronary atheromatosis was evaluated in type 1 diabetic patients with no symptoms of coronary artery disease by exercise electrocardiogram (ECG) in 39 patients and quantitative coronary angiography and by intravascular ultrasound (IVUS) examinations in 29 patients. The findings from the IVUS examinations were related to mean HbA 1c collected prospectively over 18 years. Abnormal exercise ECGs were found in 15% of patients, and angiographic diameter stenosis of >50% in one or more of the main coronary arteries was found in 34% of patients. All patients examined with intracoronary ultrasound had developed atherosclerotic plaques with an increased intimal thickness (>0.5 mm) in one or more of the coronary arteries. Coronary artery plaque formation, as judged by ultrasound, was significantly related to mean HbA 1c during 18 years (P < 0.05) after adjustment for total cholesterol and age. This study demonstrates a high prevalence of silent coronary atheromatosis in type 1 diabetic patients with no symptoms of coronary heart disease. Long-term glycemic control was shown to be associated with coronary atheromatosis.

A pproximately 10% of patients treated for hypertension remain with uncontrolled high blood pressure (BP), despite prescription of antihypertensive drugs.1 Renal sympathetic denervation has been introduced as a new treatment of hypertension apparently resistant to drug treatment.2 However, it has been known for decades that poor drug adherence is a major problem among these patients. 3,4 It is unknown to what degree the decline in BP after renal denervation (RDN) 2 is caused by denervation itself or concomitantly improved drug adherence. We aimed to investigate for the first time the BP lowering effect of RDN in treatment-resistant hypertension after witnessed intake of medication just before qualifying ambulatory BP. Methods Study Design and PatientsPatients referred specifically for RDN from hospitals and specialist practices in the southern part of Norway (n=18) after publication of the Symplicity HTN-2 study 2 were worked up in the nephrology outpatient clinic at Oslo University Hospital, Ullevål in the time period from December 2011 through June 2012. Treatment-resistant hypertension was defined as uncontrolled hypertension (office systolic BP >140 mm Hg), despite regular intake of maximally tolerated doses of ≥3 antihypertensive drugs, including a diuretic. In addition, patients had to qualify by having mean ambulatory daytime systolic BP >135 mm Hg immediately after investigator witnessed intake of their antihypertensive morning drugs. Patients were asked to bring their prescribed medication to the clinical visit with one of the investigators (one of the authors of the article). Medication was documented and administered by the investigator and swallowed by the patient under continuous observation, to secure the intake of prescribed medication in prescribed doses. Patients were then continuously under the observation by the investigator to prohibit throwing up again of the pills until 24-hour ambulatory BP device had been mounted and tested out in a somewhat more lengthy procedure than usually to prolong the period of observation. Patients stayed in the hospital for 2 hours to capture those with potential symptomatic hypotension caused by full intake of medication. Visits with subsequent ambulatory BP measurements were done in the morning, and further observation of patients in the hospital was done during working hours.Plasma and urine metabolites of drugs were not measured because these tests would not have contributed in the present situation. Such tests could have identified the nondrug compliant patients but not secured their intake of medication. See Editorial Commentary, pp 450-452Abstract-It is unknown whether the decline in blood pressure (BP) after renal denervation (RDN) is caused by denervation itself or concomitantly improved drug adherence. We aimed to investigate the BP lowering effect of RDN in true treatmentresistant hypertension by excluding patients with poor drug adherence. Patients with resistant hypertension (n=18) were referred for a thorough clinical and laboratory work-up. Treat...

The present findings suggest an important role of long-term hyperglycaemia in the development of atherosclerosis, especially in women with type 1 diabetes. Type 1 diabetes patients have earlier development of, and more advanced, atherosclerosis compared with an age- and sex-matched reference population. In women, carotid IMT reflects preclinical coronary atherosclerosis.

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