New Paradigms of Myocardial Regeneration Post-Infarction Forrester, James S., MD, FACC; White, Anthony J., MD; Matsushita, Satoshi, MD ...
JACC. Cardiovascular interventions,
2009, January 2009, 2009-01-00, Volume:
2, Issue:
1
Journal Article
Peer reviewed
Open access
New Paradigms of Myocardial Regeneration Post-Infarction: Tissue Preservation, Cell Environment, and Pluripotent Cell Sources James S. Forrester, Anthony J. White, Satoshi Matsushita, Tarun ...Chakravarty, Raj R. Makkar Three new paradigms of myocardial preservation and regeneration suggest that the goal of myocardial rejuvenation can be achieved. The first paradigm is that substantial preservation of myocardium is possible even during the period of coronary occlusion and immediate reperfusion. Myocardial preservation also creates an environment receptive to regeneration. The second paradigm is that the local environment regulates cell behavior in the ischemic/infarct region. For instance, adult cells may be induced to proliferate with appropriate environmental modification. The final paradigm is that autologous cardiac stem cells or induced pluripotent stem cells can create new myocytes and myocardium.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The Secondary Prevention of Coronary Artery Disease Merz, MD, C.Noel Bairey; Rozanski, MD, Alan; Forrester, MD, James S.
The American Journal of Medicine,
06/1997, Volume:
102, Issue:
6
Book Review, Journal Article
Peer reviewed
Randomized clinical trials demonstrate the efficacy of medical secondary prevention in coronary disease patients. The magnitude of risk reduction with exercise, diet, lipid modification, and smoking ...cessation is similar to other medical therapies for coronary disease such as aspirin, beta blockers, as well as coronary bypass surgery, (Table VI) In contrast to these therapies, however, secondary prevention stabilizes angiographic progression in about 50% of patients and induces regression in about 25% of patients. Both symptoms and perceived quality of life also are beneficially altered by secondary prevention programs, although possibly not by the magnitude reported for bypass surgery. These clinical trial results have led the American Heart Association, and the American College of Cardiology to strongly endorse secondary prevention. A reasonable projection based on these clinical trial data is that widespread use of these recommendations in the 12 million established coronary disease patients would significantly reduce coronary mortality and morbidity.
Objectives This study sought to understand the total weight of evidence regarding outcomes in coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) in unprotected ...left main coronary artery (ULMCA) stenosis. Background Following a diagnosis of significant ULMCA stenosis in an individual that is a candidate for surgery, CABG is recommended by the American College of Cardiology/American Heart Association guidelines, whereas PCI is not recommended (Class III). Methods Databases were searched for clinical studies that reported outcomes after PCI and CABG for the treatment of ULMCA stenosis. Ten studies were identified that included a total of 3,773 patients. Results Meta-analysis showed that death, myocardial infarction, and stroke (major adverse cardiovascular or cerebrovascular events) were similar in the PCI- and CABG-treated patients at 1 year (odds ratio OR: 0.84 95% confidence interval: 0.57 to 1.22), 2 years (OR: 1.25 95% CI: 0.81 to 1.94), and 3 years (OR: 1.16 95% CI: 0.68 to 1.98). Target vessel revascularization was significantly higher in the PCI group at 1 year (OR: 4.36 95% CI: 2.60 to 7.32), 2 years (OR: 4.20 95% CI: 2.21 to 7.97), and 3 years (OR: 3.30 95% CI: 0.96 to 11.33). There was no difference in mortality in PCI- versus CABG-treated patients at 1 year (OR: 1.00 95% CI: 0.70 to 1.41), 2 years (OR: 1.27 95% CI: 0.83 to 1.94), and 3 years (OR: 1.11 95% CI: 0.66 to 1.86). Conclusions Our analysis reveals no difference in mortality or major adverse cardiovascular or cerebrovascular events, for up to 3 years, between PCI and CABG for the treatment of ULMCA stenosis. However, PCI patients had a significantly higher risk of target vessel revascularization. In selected patients with ULMCA stenosis, PCI is emerging as an acceptable option.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Harold James Charles (“Jeremy”) Swan, MD, PhD Forrester, James S.; Kaul, Sanjay; Shah, Prediman K.
The American journal of cardiology,
05/2006, Volume:
97, Issue:
10
Journal Article
Peer reviewed
Open access
Jeremy Swan is best known to the current generation of physicians as the co-inventor of the Swan-Gatz catherter. Swan died Feb 7, 2006.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Reduced heart rate variability (HRV) and increased C-reactive protein (CRP) levels are both predictors of coronary artery disease and correlate with each other. We examined whether these 2 phenotypes ...share a common genetic substrate and investigated the relations of the CRP gene polymorphisms with both CRP levels and HRV indexes. We examined 236 male twins free of symptomatic coronary artery disease, with a mean age ± SD of 54 ± 2.9 years. The plasma CRP levels were measured and the frequency domain measures of HRV were assessed using a 24-hour electrocardiographic recording, including ultra-low-, very-low-, low-, and high-frequency power. Three single-nucleotide polymorphisms in the CRP gene were genotyped. Generalized estimating equations were used to examine the association between CRP and HRV, as well as the genotype-phenotype association. Bivariate structural equation modeling was performed to estimate the genetic and environmental correlations between CRP and HRV and the explanatory effect of CRP gene polymorphisms on the CRP-HRV association. Both CRP (h2 = 0.76) and HRV indexes (h2 = 0.56 to 0.64) showed high heritability. Greater CRP levels were significantly associated with lower HRV. A robust genetic correlation was found between CRP and ultra-low-frequency power (rG = −0.3, p = 0.001). One CRP single nucleotide polymorphism (rs1205) was significantly associated with both CRP (p = 0.003) and ultra-low-frequency power (p = 0.005) and explained 11% of the genetic covariance between them. In conclusion, reduced HRV correlates significantly with increased CRP plasma levels and this correlation is due, in large part, to common genetic influences. A polymorphism in the CRP gene contributes to both CRP levels and HRV.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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