Advanced atherosclerosis is often associated with dystrophic calcification and remodeling of extracellular matrix of vascular wall. Recently many studies have documented a general relationship between calcification and severity of coronary disease, and discussed the feasibility of electron beam computed tomography for detecting and quantifying the coronary artery calcification in the patients. The present study investigated the expression and the localization of osteopontin, one of noncollagenous bone matrix protein, within the calcified coronary arteries. Autopsy-derived coronary artery specimens were scanned and reconstructed to visualize the pattern of coronary calcification using a novel microscopic computed tomography technique. The localization of the osteopontin were evaluated by immunohistochemial stain with LF7. The present study showed that the pattern of coronary calcification is variable and the expression of osteopontin is localized mainly to calcified lesion. The smooth muscle cells in addition to macrophage expressed osteopontin protein in human coronary atherosclerotic plaques. Soluble osteopontin released near to the sites of vascular calcification may represent an adaptive mechanism aimed at regulating the process of vascular calcification.
Aged ; Calcinosis/metabolism ; Coronary Arteriosclerosis/pathology* ; Coronary Arteriosclerosis/metabolism* ; Coronary Vessels/pathology* ; Coronary Vessels/metabolism ; Coronary Vessels/chemistry* ; Female ; Human ; Immunohistochemistry ; Male ; Middle Age ; Sialoglycoproteins/biosynthesis ; Sialoglycoproteins/analysis*

Animals ; Coronary Vessels ; surgery ; Drug-Eluting Stents ; adverse effects ; Lactic Acid ; chemistry ; Polyesters ; Polymers ; chemistry ; Sirolimus ; chemistry ; therapeutic use ; Swine

OBJECTIVETo study the safety of the novel high nitrogen nickel-free austenitic stainless steel bare metal stents (BMS) in a recognized porcine coronary model and to select a better grid structure of it.

METHODSThree types of stents were randomly implanted in different coronary arteries of the same pig: 316 L stainless steel BMS (316 L-BMS) (n=12), novel high nitrogen nickel-free stents Grid A (NF-A-BMS) (n=12) and novel high nitrogen nickel-free stents Grid B (NF-B-BMS) (n=12). In total, eighteen animals underwent successful random placement of 36 oversized stents in the coronary arteries. Coronary angiography was performed after 36 d of stents implantation. Nine animals were respectively sacrificed after 14 d and 36 d for histomorphologic analysis.

RESULTSQuantitative coronary angiography (QCA) showed similar luminal loss (LL) in the three groups: (0.21 ± 0.17) mm for 316 L-BMS, (0.16 ± 0.12) mm for NF-A-BMS, (0.24 ± 0.15) mm for NF-B-BMS (P>0.05). Histomorphomeric analysis after 15 d and 36 d revealed that there was also no significant difference among the three groups in neointimal area (NA) with similar injury scores respectively. High magnification histomorphologic examination showed similar inflammation scores in the three groups, but NF-A-BMS group had poorer endothelialization scores compared with NF-B-BMS group, 2.00 ± 0.63 vs. 2.83 ± 0.41 (P=0.015) at 15 d, which also could be proved by the scanning electron microscope. However, the difference could not been observed at 36 d.

CONCLUSIONThe novel NF-BMS showed similar safety as 316 L-BMS during the short-term study. NF-B-BMS had better endothelialization than NF-A-BMS and this may owe to the specific strut units.

Animals ; Coronary Vessels ; Nickel ; Nitrogen ; Random Allocation ; Stainless Steel ; chemistry ; Stents ; Swine ; Swine, Miniature

BACKGROUND AND OBJECTIVES: Late coronary in-stent restenosis remains an important clinical problem in coronary intervention. The effects of Paclitaxel (Taxol), an antimicrotubule agent, on neointimal proliferation within porcine coronary arteries were evaluated. METHOD: Stent overdilation injury was performed in porcine coronary arteries without local delivery of paclitaxel (n=10, Group I). Stent overdilation injury was also performed after local delivery of paclitaxel nanoparticle using the Dispatch Catheter(TM) in other coronary arteries (n=10, Group II). Coronary angiography and histopathologic examinations, which were performed 4 weeks after stenting, and complete blood counts and blood chemistry before and 4 weeks after the local delivery were compared. RESULT: 1) Reference vessel diameter, stented artery diameter, and diameter stenosis were not different between two groups. 2) Histopathologic injury score, external elastic lamina area, internal elastic lamina area, and luminal area were not different between two groups. 3) Neointimal area and histopathologic area stenosis were smaller significantly in the group II than in group I (2.3+/-0.33 vs 3.7+/-1.40 mm2, 22.2+/-19.26 vs 31.1+/-7.15%: p=0.04, 0.03, respectively). 3) Proliferating cell nuclear antigen index was lower in the stent overdilation injury with local paclitaxel delivery group than in the stent overdilation injury alone (31.10+/-3.70 vs 46.80+/-5.20%, p=0.04). 4) No significant laboratory changes were observed before and 4 weeks after the local delivery. CONCLUSION: Local delivery of paclitaxel nanoparticle inhibits neointima formation after stent overdilation injury in porcine coronary arteries without systemic toxicity.
Arteries ; Blood Cell Count ; Chemistry ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Nanoparticles* ; Neointima ; Paclitaxel* ; Phenobarbital ; Proliferating Cell Nuclear Antigen ; Stents*

No abstract available.
Calcium/*analysis ; Coronary Artery Disease/*epidemiology ; Coronary Vessels/*chemistry ; Female ; Humans ; Male ; Metabolic Syndrome X/*epidemiology ; Vascular Calcification/*epidemiology

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Coronary Vessels ; injuries ; Drug-Eluting Stents ; Humans ; Male ; Polytetrafluoroethylene ; chemistry ; therapeutic use

OBJECTIVETo investigate the difference of soluble P-selectin levels in different subtype of coronary heart disease and the relationship between soluble P-selectin levels with the severity of coronary artery lesions.

METHODSEnzyme linked immuoserbent assay (ELISA) was used to measure the plasma soluble P-selectin levels in 69 patients with angiocardiography documented coronary heart disease and 19 normal coronary arteries persons without angiocardiography detectable coronary artery disease (control group). The coronary artery lesions score was recorded according to single, double and triple-vessel lesions while the American College of Cardiology and the American Heart Association proposed type A, B, C lesion and Gensini scoring system. The relationships between plasma soluble P-selectin levels and the coronary artery score (the severity of coronary heart disease) were assessed.

RESULTS(1) The level of plasma soluble P-selectin was obviously higher in the coronary heart disease group than in the control group (180.6 +/- 60.5 ng/L vs. 145.3 +/- 21.7 ng/L, P<0.05). (2) The level of plasma soluble P-selectin was significantly higher in the acute coronary syndrome group (191.4 +/- 63.7 ng/L) than in the control group (145.3 +/- 21.7 ng/L, P< 0.01) and in the stable angina pectoris group (141.3 +/- 17.9 ng/L, P<0.01). (3) The level of plasma soluble P-selectin was high in multi-vessel coronary artery lesions group than in single-vessel group (190.1 +/- 64.2 ng/L vs. 157.2 +/- 43.4 ng/L, P < 0.05). The level of plasma soluble P-selectin was positively correlated with the Gensini score (r = 0.391, P = 0.001); the numbers of vessels lesions (rs = 0.349, P = 0.003); Type A, B and C lesions (rs = 0.358, P = 0.002).

CONCLUSIONThe positive correlation between the level of soluble P-selectin and the coronary artery score may indicate that soluble P-selectin levels might reflect the severity of coronary heart disease. The elevated soluble P-selectin level in acute coronary syndrome suggested the possible relation of P-selectin to the pathogenesis of acute coronary syndrome, which may save as a potential marker of plaque unstability.

Case-Control Studies ; Coronary Disease ; blood ; physiopathology ; Coronary Vessels ; pathology ; Female ; Humans ; Male ; Middle Aged ; P-Selectin ; blood ; chemistry ; Solubility

PURPOSE: To determine the differences in clinical characteristics, blood chemistry and coronary artery complications between patients with Kawasaki disease who received intravenous immunoglobulin (IVIG) within the fourth day of illness and after the fifth day of illness. METHODS: A retrospective chart review was conducted of all children with Kawasaki disease who were admitted to Ewha Mokdong Hospital between January 2001 and June 2002. The early treatment group received IVIG within the fourth day of illness(n=34) and the control group received IVIG after the fifth day of illness(n=53). Clinical manifestations, fever duration, hospitalization days, CBC, blood chemistry and coronary artery complications were compared between two groups. RESULTS: No demographic differences were noted between the two groups(P>0.05). Total duration of fever was significantly shorter in the early treatment group than the control group(4.8+/-2.5 days vs 7.4+/-3.0 days, P<0.05), but there were no differences in fever duration after IVIG treatment and hospitalization days between two groups(P>0.05). No significant differences were noted in the level of hemoglobin, WBC, ESR, CRP, AST, ALT and albumin between two groups(P>0.05). No significant differences in the incidence of IVIG retreatment were noted between the two groups(11.8% vs 5.7%, P>0.05). No significant differences in the incidence of coronary artery complications were noted between the two groups(11.7% vs 18.9%, P>0.05). No significant differences in the recurrence rate were noted between the two groups(3% vs 2%, P>0.05). CONCLUSION: Early IVIG treatment in patients with Kawasaki disease reduces the total fever duration. Coronary artery complications were not increased in patients with early IVIG treatment.
Chemistry ; Child ; Coronary Vessels ; Fever ; Hospitalization ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Recurrence ; Retreatment ; Retrospective Studies

A large number of major cardiovascular events occur in patients due to minimal or some lumen narrowing of the coronary artery. Recent biological studies have shown that the biological composition or vulnerability of the plaque is more critical for plaque rupture compared to the degree of stenosis. To overcome the limitations of anatomical images, molecular imaging techniques have been suggested as promising imaging tools in various fields. F-18 fluorodeoxyglucose (FDG), which is widely used in the field of oncology, is an example of molecular probes used in atherosclerotic plaque evaluation. FDG is a marker of plaque macrophage glucose utilization and inflammation, which is a prominent characteristic of vulnerable plaque. Recently, F-18 fluoride has been used to visualize vulnerable plaque in clinical studies. F-18 fluoride accumulates in regions of active microcalcification, which is normally observed during the early stages of plaque formation. More studies are warranted on the accumulation of F-18 fluoride and plaque formation/vulnerability; however, due to high specific accumulation, low background activity, and easy accessibility, F-18 fluoride is emerging as a promising non-invasive imaging probe to detect vulnerable plaque.
Atherosclerosis/pathology/*radiography ; Coronary Vessels ; Fluorodeoxyglucose F18/chemistry ; Humans ; Plaque, Atherosclerotic ; *Positron-Emission Tomography ; *Tomography, X-Ray Computed

BACKGROUNDTo overcome the drawbacks of permanent stents, biodegradable stents have been studied in recent years. The bioabsorbable polymer vascular scaffold (BVS) was the first bioabsorbable stent to undergo clinical trials, demonstrating safety and feasibility in the ABSORB studies. Iron can potentially serve as the biomaterial for biodegradable stents. This study aimed to assess the short-term safety and efficacy of a biodegradable iron stent in mini-swine coronary arteries.

METHODSEight iron stents and eight cobalt chromium alloy (VISION) control stents were randomly implanted into the LAD and RCA of eight healthy mini-swine, respectively. Two stents of the same metal base were implanted into one animal. At 28 days the animals were sacrificed after coronary angiography, and histopathological examinations were performed.

RESULTSHistomorphometric measurements showed that mean neointimal thickness ((0.46 ± 0.17) mm vs. (0.45 ± 0.18) mm, P = 0.878), neointimal area ((2.55 ± 0.91) mm(2) vs. (3.04 ± 1.15) mm(2), P = 0.360) and percentage of area stenosis ((44.50 ± 11.40)% vs. (46.00 ± 17.95)%, P = 0.845) were not significantly different between the iron stents and VISION stents. There was no inflammation, thrombosis or necrosis in either group. The scanning electron microscopy (SEM) intimal injury scores (0.75 ± 1.04 vs. 0.88 ± 0.99, P = 0.809) and number of proliferating cell nuclear antigen (PCNA) positive staining cells were not significantly different between the two groups. The percentage of neointimal coverage by SEM examination was numerically higher in iron stents than in VISION stents ((84.38 ± 14.50)% vs. (65.00 ± 22.04)%, P = 0.057), but the difference was not statistically significant. Iron staining in the tissue surrounding the iron stents at 28 days was positive and the vascular wall adjacent to the iron stent had a brownish tinge, consistent with iron degradation. No abnormal histopathological changes were detected in coronary arteries or major organs.

CONCLUSIONSThe biodegradable iron stent has good biocompatibility and short-term safety and efficacy in the miniswine coronary artery. Corrosion of iron stents is observed at four weeks and no signs of organ toxicity related to iron degradation were noted.

Absorbable Implants ; adverse effects ; Animals ; Coronary Vessels ; surgery ; Iron ; chemistry ; Microscopy, Electron, Scanning ; Stents ; adverse effects ; Swine