BACKGROUND: MicroRNAs (miRNAs) are endogenous small RNAs 21-25 nucleotides in length. Recently, we reported that miRNA 208 (miR-208) is produced exclusively in the rat myocardium and that plasma miR-208 is a biomarker of myocardial injury in rats. In the present study, we assessed the hypothesis that plasma concentrations of myocardial-specific miRNAs can be used to diagnose myocardial injury in humans.

In patients with fulminant myocarditis, percutaneous ECMO is a highly effective form of a haemodynamic support. Once a patient recovers from inflammatory myocardial damage, the subsequent clinical outcome is favourable, similar to that observed in patients with acute non-fulminant myocarditis.

Six months of DAPT was not inferior to 18 months of DAPT following implantation of a DES with a biodegradable abluminal coating. However, this result needs to be interpreted with caution given the open-label design and wide noninferiority margin of the present study. (Nobori Dual Antiplatelet Therapy as Appropriate Duration [NIPPON]; NCT01514227).

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everal population-based studies have shown that metabolic syndrome (MeS) is an independent predictor of cardiovascular diseases, including acute myocardial infarction (AMI). [1][2][3] It has also become clear that MeS is strongly associated with systemic inflammation characterized by high levels of C-reactive protein (CRP). 4,5 Although the number of deaths caused by AMI has declined over the past decade, the incidence of recurrent myocardial infarction (MI) is unchanged, 6,7 which indicates the importance of understanding the underlying risk factors that lead to secondary cardiac events. Therefore, this study was designed to investigate the long-term prognostic impact of MeS in patients with AMI. Circulation Journal Vol.72, March 2008 Methods Study PatientsFrom January 2000 to December 2002, 465 patients who had an AMI without a previous MI were admitted to the coronary care unit of the National Cardiovascular Center, Japan. Four patients complicated with severe inflammatory diseases such as sepsis, pneumonia and pyelonephritis were excluded, leaving a total of 461 patients who were retrospectively analyzed in the present study. The study protocol was approved by the institutional review board. DefinitionsAMI was defined as the presence of any 2 of the following 3 conditions: typical chest pain for at least 30 min, typical electrocardiogram changes (ST elevation, ST depression, T inversion and new pathological Q waves in at least 2 adjacent leads) and elevation of serum creatine kinase level to more than twice the upper normal limit.Significant coronary artery stenosis was defined as stenosis in more than 75% of the vessels. Multivessel coronary disease was defined as a significant stenosis of 1 or more vessels other than the infarct-related artery. Left main coronary disease was considered to be double vessel involvement. Left ventricular ejection fraction (LVEF) was measured by the Simpson's method on left ventriculography or echocardiography, and left ventricular dysfunction was defined as a LVEF <40%. Congestive heart failure at admission was diagnosed on the basis of physical examination, such as presence of moist rales on chest auscultation and Background Population-based cohort studies demonstrate that metabolic syndrome (MeS) is associated with increased risk for cardiovascular diseases and related mortalities. The present study was designed to investigate the prognostic impact of MeS in patients with acute myocardial infarction (AMI). Methods and ResultsThe study group was 461 AMI patients without a history of previous myocardial infarction. On the basis of the National Cholesterol Education Program Adult Treatment Panel III criteria, MeS was defined having at least 3 of the following 5 conditions: dysglycemia (impaired fasting glucose, current use of insulin or oral hypoglycemic drugs), hypertriglyceridemia, low high-density lipoprotein-cholesterol level, hypertension and obesity. The prevalence of MeS was 37% (n=172). C-reactive protein (CRP) levels increased with the increase in the number of condit...

OBJECTIVE -We investigated the morphological characteristics of coronary arteries in patients with impaired glucose tolerance (IGT) using computer-assisted quantitative coronary angiography. IGT is an independent risk factor for cardiovascular disease. However, the morphological changes developing in the coronary arteries of patients with IGT remain unknown.RESEARCH DESIGN AND METHODS -A total of 534 patients with angina pectoris were studied. Of these, 144 patients were being treated for diabetes. The remaining 390 patients were classified as follows depending on the results of a 75-g oral glucose tolerance test: normal glucose tolerance (NGT) (n ϭ 117), impaired fasting glucose (n ϭ 3), IGT (n ϭ 136), and diabetes pattern (preclinical diabetes) (n ϭ 134). The diameters of the middle section of all major coronary artery segments were measured and averaged to determine the averaged vessel diameter (AVD). We defined segments of a diameter of Յ1.5 mm as diseased lesions and determined the averaged lesion length (ALL).RESULTS -AVD and ALL were significantly different among patients with IGT and those with NGT. Patients with diabetes (preclinical and/or treated) had smaller AVD and longer ALL than those with IGT. By multivariate analysis, postprandial glucose levels were shown to be independently associated with an AVD Ͻ3.0 mm and an ALL Ͼ20 mm.CONCLUSIONS -Diffuse coronary artery narrowing develops not only in patients with diabetes but also in those with IGT. This morphological change is associated with postprandial hyperglycemia. Diabetes Care 28:2217-2222, 2005I mpaired glucose tolerance (IGT) has been regarded as intermediate between normal glucose tolerance (NGT) and overt diabetes. Recently, evidence has been accumulating that IGT may play a pathological role as one aspect of the metabolic syndrome. Epidemiological studies, i.e., the Funagata and DECODE (Diabetes Epidemiology: Collaborative Analysis of Diagnostic Criteria in Europe) studies (1,2), indicated that IGT characterized as postprandial hyperglycemia is an independent risk factor for cardiovascular disease. However, it is not known whether morphological changes develop in the coronary arteries of patients with IGT, as in those of diabetic patients for whom small vessel diameter and long lesion length (diffuse narrowing) are found in multiple vessels (3,4). In the present study, we assessed coronary angiographic features in patients with IGT by using computer-assisted quantitative analysis. RESEARCH DESIGN AND METHODS -From April 2000 toJune 2002, 1,529 patients were hospitalized due to nonischemic and ischemic heart disease in our facility of the National Cardiovascular Center, a tertiary referral hospital in the northern district of Osaka, Japan. We obtained informed consent and performed quantitative coronary angiography (QCA) in patients with recurrent chest pain associated with electrocardiographic and/or echocardiographic evidence of myocardial ischemia and without contraindications to the administration of iodinated contrast agent (e.g., predia...

Percutaneous coronary intervention with SES in HD patients has a higher incidence of repeat revascularization and mortality compared with those in NH patients. Haemodialysis appears to be strongly associated with mortality and repeat revascularization even after SES implantation.

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