Relative risk of plaque erosion among different age and sex groups in patients with acute coronary syndrome

Postmortem studies reported plaque erosion is frequent in young women. Recent in vivo studies failed to show age and sex differences in the plaque erosion prevalence. The aim of this study was to investigate the prevalence of plaque erosion by age and sex among acute coronary syndromes (ACS) patients. From 1699 ACS patients, 1083 with plaque erosion or rupture were analyzed. Patients were categorized as 5 age groups (≤?50, 51–60, 61–70, 71–80,?≥?81 years). Overall prevalence of plaque erosion was similar between males and females (p?=?0.831). Males age?≤?50 had higher (p?=?0.018) and age 71–80 had lower (p?=?0.006) prevalence of plaque erosion. Females age 61–70 had higher (p?=?0.021) and age 71–80 had lower (p?=?0.045) prevalence of plaque erosion. In advanced age groups (≥?71 years), rupture was the dominant etiology in both sexes. In multivariate analysis of males, age?≤?50 demonstrated a trend to increase (OR 1.418, 95% CI 0.961–2.093, p?=?0.078) the erosion risk. Females age?≤?70 independently increased (OR 2.138, 95% CI 1.249–3.661, p?=?0.006) the risk for erosion. The prevalence of plaque erosion was similar between males and females. Plaque erosion risk was increased in the males age?≤?50 and in the females age?≤?70 among ACS patients.

     

Temporal,spatial, and genetic constraints contribute to the patterning and penetrance of murine neurofibromatosis-1 optic glioma

BackgroundBrain tumors are the most common solid tumors of childhood, but little is understood about the factors that influence their development. Pediatric low-grade gliomas in particular display unique temporal and spatial localization associated with different genetic mutations (eg, BRAF genomic alterations, mutations in the neurofibromatosis type 1 [NF1] gene) for reasons that remain unclear. NF1 low-grade gliomas typically arise in the optic pathway of young children as optic pathway gliomas (OPGs), likely from a cell of origin that resides within the third ventricular zone (TVZ). However, the factors that contribute to their distinct temporal patterning and penetrance have not been adequately explored.MethodsTVZ neuroglial progenitor cells (NPCs) were analyzed over the course of mouse brain development. Progenitors isolated by fluorescence-activated cell sorting (FACS) were assessed for functional and molecular differences. The impact of different germline Nf1 mutations on TVZ NPC properties was analyzed using genetically engineered mice.ResultsWe identify 3 individual factors that could each contribute to Nf1 optic glioma temporal patterning and penetrance. First, there are 3 functionally and molecularly distinct populations of mouse TVZ NPCs, one of which (“M” cells) exhibits the highest clonogenic incidence, proliferation, and abundance during embryogenesis. Second, TVZ NPC proliferation dramatically decreases after birth. Third, germline Nf1 mutations differentially increase TVZ NPC proliferation during embryogenesis.ConclusionsThe unique temporal patterning and penetrance of Nf1 optic glioma reflects the combined effects of TVZ NPC population composition, time-dependent changes in progenitor proliferation, and the differential impact of the germline Nf1 mutation on TVZ NPC expansion.     

Numerical and experimental investigations of the flow–pressure relation in multiple sequential stenoses coronary artery

Virtual fractional flow reserve (vFFR) has been evaluated as an adjunct to invasive fractional flow reserve (FFR) in the light of its operational and economic benefits. The accuracy of vFFR and the complexity of hyperemic flow simulation are still not clearly understood. This study investigates the flow–pressure relation in an idealised multiple sequential stenoses coronary artery model via numerical and experimental approaches. Pressure drop is linearly correlated with flow rate irrespective of the number of stenosis. Computational fluid dynamics results are in good agreement with the experimental data, demonstrating reasonable accuracy of vFFR. It was also found that the difference between data obtained with steady and pulsatile flows is negligible, indicating the steady flow may be used instead of pulsatile flow conditions in vFFR computation. This study adds to the current understanding of vFFR and may improve its clinical applicability as an adjunct to invasively determined FFR.     

Perforation of saphenous vein graft during coronary stenting: A case report

We report on a case of coronary perforation during stenting of a saphenous vein graft with a biliary stent. Sealing of the perforation was achieved with another biliary stent deployed within the first stent at the site of the perforation, and with prolonged balloon inflation. This case illustrates that vein graft perforation can occur with coronary stenting, and could potentially be treated with prolonged balloon inflation and/or stenting at the site of the first stent. © 1996 Wiley-Liss, Inc.