Studies examining the effects of tirofiban combined with other conventional drugs for treating patients with acute coronary syndrome (ACS) are lacking. Thus, in this study, we conducted a meta-analysis investigating both the safety and efficacy of intracoronary (IC) administration of tirofiban treatment alone versus in combination with other conventional treatments for the no-reflow phenomenon (NRP) during percutaneous coronary intervention (PCI) in patients with ACS. PubMed, Cochrane Library, Embase, Chinese Biomedical (CBM), Google Scholar, and China National Knowledge Infrastructure (CNKI) databases were searched for randomized controlled trials (RCTs) that included data comparing tirofiban treatment alone versus in combination with other conventional therapies. Two independent reviewers evaluated the quality of all data and studies were evaluated according to the Cochrane Collaboration Handbook 5.3. Thirteen RCTs involving 937 patients were included in our analysis. Tirofiban plus conventional drug treatment improved thrombolysis in myocardial infarction (TIMI) grade 3 flow (OR: 0.18; 95% CI: 0.11–0.30; p<0.01), corrected TIMI frame count (CTFC) (WMD: 6.61; 95% CI: 4.69–8.53; p<0.01), and corrected left ventricular ejection fraction (LVEF) (WMD: −3.76; 95% CI: −4.70 to −2.82; p<0.01) and reduced major adverse cardiovascular events (MACE) (OR: 3.9; 95% CI; 2.51–6.07; p<0.01). Tirofiban plus conventional therapy reduced bleeding; however, no statistical significance was observed (OR: CI: 0.50–3.12; p=0.64). IC administration of tirofiban combined with conventional drugs is more effective than tirofiban treatment alone for no-reflow (NR) during PCI without increasing bleeding events. This combination is recommended as an optimal strategy for preventing NR.

Snakebite envenoming adversely affects human health and life worldwide. Presently, no suitable diagnostic tools for snakebite envenoming are available in China. Therefore, we sought to develop reliable diagnostic tests for snakebite management. We conducted affinity purification experiments to prepare species-specific antivenom antibody (SSAb). In brief, affinity chromatography with an antibody purification column (Protein A) was conducted to purify immunoglobulin G from Bungarus multicinctus (BM) venom hyperimmunized rabbit serum. The cross-reactive antibodies were removed from commercial BM antivenin by immune adsorption on the affinity chromatography columns of the other three venoms, Bungarus Fasciatus (FS), Naja atra (NA), and O. hannah (OH), generating SSAb. The results of western blot analysis and enzyme-linked immunosorbent assay (ELISA) showed the high specificity of the prepared SSAb. The obtained antibodies were then applied to ELISA and lateral flow assay (LFA) to detect BM venom. The resulting ELISA and LFA could specifically and rapidly detect BM venom in various samples with the limits of quantification as 0.1 and 1 ng/ml, respectively. This method could effectively detect snake venom in experimentally envenomed rats (simulating human envenomation), which could distinguish positive and negative samples within 10–15 min. This method also showed promise in serving as a highly useful tool for a rapid clinical distinguishing of BM bites and rational use of antivenom in emergency centers. The study also revealed cross-reactivity between BM and heterogenous venoms, suggesting that they shared common epitopes, which is of great significance for developing detection methods for venoms of the snakes belonging to the same family.

Background: Inflammatory factors are well-established indicators for vascular disease, but the D-dimer to lymphocyte count ratio (DLR) is not measured in routine clinical care. Screening of DLR in individuals may identify individuals at in-hopital mortality of acute aortic dissection (AD). Methods: A retrospective analysis of clinical data from 2013 to 2020 was conducted to identify which factors were related to in-hospital mortality risk of AD. Baseline clinical features, cardiovascular risk factors, and laboratory parameters were obtained from the hospital database. The end point was in-hospital mortality. Forward conditional logistic regression was performed to identify independent risk factors for AA in-hospital death. The cutoff value of the DLR should be ideally calculated by receiver operating characteristic (ROC) analysis. Results: The in-hospital mortality rate was 15% (48 of 320 patients). Patients with in-hospital mortality had a higher admission mean DLR level than the alive group (1740 vs. 1010, P < .05). The cutoff point of DLR was 907. The in-hospital mortality rate in the high-level DLR group was significantly higher than that in the low-level DLR group (P < .05). Univariate analysis showed that 8 of 38 factors were associated with in-hospital mortality (P < .05), including admission WBC, neutrophils, lymphocytes, neutrophils/lymphocytes (NLR), prothrombin time (PT), heart rate (HR), D-dimer, and DLR. In multivariate analysis, DLR (odds ratio [OR] 2.127, 95% CI 1.034–4.373, P = 0.040), HR (odds ratio [OR] 1.016, 95% CI 1.002–1.030, P = 0.029) and PT (odds ratio [OR] 1.231, 95% CI 1.018–1.189, P = 0.032) were determined to be independent predictors of in-hospital mortality (P < .05). Conclusion: Compared with the common clinical parameters PT and HR, serum DLR level on admission is an uncommon but independent parameter that can be used to assess in-hospital mortality in patients with acute AD.

Article: Bioinformatics analysis of the role of cuproptosis gene in acute myocardial infarction - Minerva Cardiology and Angiology 2024 Jun 05 - Minerva Medica - Journals