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Long-term outcomes of titanium-nitride-oxide coated stents and drug-eluting stents in acute coronary syndrome:A systematic review and meta-analysis

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World Journal of Cardiology 2024年第5期16卷 293-305页

作者： muhammad Ahmed Ali Fahim Afia Salman Hira Anas Khan Syed muhammad Hasan Muskan FatimaBhojani Sarah Aslam Amna Zia Ul Haq Vishal Reddy Bejugam Beena Muntaha Nasir Wajiha Gul Abdul Moeed Abdelrahman S Abdalla muhammad Majid muhammad sohaib asghar Md Al Hasibuzzaman Department of Internal Medicine Dow University of Health SciencesKarachi 74200Pakistan Department of Internal Medicine North Central Bronx HospitalBronxNY 10467United States Department of Urology Center for Academic MedicineStanford University School of MedicinePalo AltoCA 33872United States Department of Cardiovascular Imaging Cleveland ClinicClevelandOH 44195United States Division of Nephrology and Hypertension Mayo Clinic RochesterRochesterMN 55905United States Institute of Nutrition and Food Science University of DhakaDhaka 1000Bangladesh

BACKGROUND In severe cases of coronary artery disease,percutaneous coronary intervention provide promising results.The stent used could be a drug-eluting stent(DES)or a titanium-nitride-oxide coated stent(TiNOS).AIM To compare the 5-year effectiveness and safety of the two stent types.METHODS The following systematic review and meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis guidelines,and PubMed/MEDLINE,Scopus,and Cochrane Central were searched from inception till August 2023.Primary outcomes were major adverse cardiac events(MACE),cardiac death,myocardial infarction(MI),cardiac death or MI,and ischemia-driven total lesion revascularization(ID-TLR).RESULTS Four randomized controlled trials(RCT),which analyzed a sum total of 3045 patients with acute coronary syndrome(ACS)after a median follow-up time of 5 years were included.Though statistically insignificant,an increase in the ID-TLR was observed in patients receiving TiNOSs vs DESs.In addition,MI,cardiac death and MI,and definite stent thrombosis(DST)were significantly decreased in the TiNOS arm.Baseline analysis revealed no significant results with meta-regression presenting non-ST elevated MI(NSTEMI)as a statistically significant covariate in the outcome of MACE.CONCLUSION TiNOS was found to be superior to DES in terms of MI,cardiac death or MI,and DST outcomes,however,the effect of the two stent types on ID-TLR and MACE was not significant.A greater number of studies are required to establish an accurate comparison of patient outcomes in TiNOS and DES.

关键词： Stents Drug-eluting Major adverse cardiac events All-cause death Meta-analysis

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Tocilizumab in severe COVID-19-A randomized,double-blind,placebo-controlled trial

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Infectious Medicine 2022年第2期1卷 88-94页

作者： muhammad Irfan Malik Sardar Al Fareed Zafar Fabiha Qayyum Muna Malik muhammad sohaib asghar muhammad Junaid Tahir Ammarah Arshad Fatima Khalil Hafiza Shafia Naz Mudassar Aslam Jodat Saleem Abdul Aziz Mustafa Usman Azhar muhammad Naqash Zohaib Yousaf Postgraduate Medical Institute LahorePakistan Lahore General Hospital LahorePakistan Ameer-ud-Din Medical College LahorePakistan Dow University of Health Sciences-Ojha Campus KarachiPakistan Sheikh Zayed Medical College Rahim Yar KhanPakistan Hamad Medical Corporation DohaQatar

Background:The therapeutic effectiveness of interleukin-6 receptor inhibitor in critically ill hospitalized patients with coronavirus disease 2019(COVID-19)is uncertain.Methods:To evaluate the efficacy and safety of the outcome as recovery or death of tocilizumab for severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2)infection,we conducted a randomized,double-blinded,placebo-controlled phase 2 trial in critically ill COVID-19 adult patients.The patients were randomly assigned in a 4:1 ratio to receive standard medical treatment plus the recommended dose of either tocilizumab or the placebo drug.Randomization was stratified.The primary outcome was the recovery or death after administration of tocilizumab or a placebo drug.The secondary outcomes were clinical recovery or worsening of the patients’symptoms and inflammatory markers and discharge from the hospital.Results:Of 190 patients included in this study,152 received tocilizumab,and 38 received a placebo.The duration of hospital stay of the interventional group was 12.9±9.2,while the placebo group had a more extended hospital stay(15.6±8.8).The mortality ratio for the primary outcome,ie,mortality or recovery in the tocilizumab group was 17.8%;p=0.58 by log-rank test).The mortality ratio in the placebo group was 76.3%;p=0.32 by log-rank test).The inflammatory markers in the tocilizumab group significantly declined by day 16 compared to the placebo group.Conclusions:The use of tocilizumab was associated with decreased mortality,earlier improvement of inflamma-tory markers,and reduced hospital stay in patients with severe COVID-19.

关键词： Inflammatory Infectious Immunosuppression COVID-19 Therapy Trial

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The Interrelationship of Micro-Meso and Macroscopic Structures on the Western Limb of the Hazara Kashmir Syntaxis, Pakistan

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Acta Geologica Sinica(English Edition) 2017年第5期91卷 1573-1623页

作者： sohaib AHMAD asghar ALI Khaista REHMAN Department of Geology University of PeshawarPakistan National Centre of Excellence in Geology University of PeshawarPakistan

Detailed micro-meso to macroscopic structural analyses reveal two deformation phases in the western limb of the Hazara-Kashmir Syntaxis（HKS）. Bulk top to NW shearing transformed initially symmetrical NNE-SSW trending meso to macroscopic folds from asymmetric to overturned ones without changing their trend. Sigmoidal en-echelon tension gashes developed during this deformation,that were oblique to bedding parallel worm burrows and bedding planes themselves. Strain analyses of deformed elliptical ooids using the Rf/Ф method constrain the internal strain patterns of the NNE-SSW structures. The principal stretching axis（S3） defined by deformed elliptical ooids is oriented N27°E at right angles to WNW-ESE shortening. The deformed elliptical ooids in sub-vertical bedding vertical planes contain ooids that plunge -70° SE due to NW-directed tectonic transport. Finite strain ratios are1.45（Rxy） parallel to bedding plane and 1.46（Ryz） for the vertical plane. From these 2D strain values, we derive an oblate strain ellipsoidal in 3D using the Flinn and Hsu/Nadai techniques. Strains calculated from deformed elliptical ooids average-18.10% parallel to bedding and-18.47% in the vertical plane.However, a balanced cross-section through the study area indicates a minimum of--28% shortening.Consequently, regional shortening was only partially accommodated by internal deformation.

关键词： Hazara-Kashmir Syntaxis meso to macroscopic folds sigmoidal en-echelon gash fractures deformed elliptical ooids, Rf/Ф method

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