Differences in the inflammatory response between patients with and those without diabetes mellitus after coronary stenting.
ABSTRACT Patients with diabetes mellitus who undergo coronary stenting are at increased risk of restenosis. It is known that inflammation plays a crucial role in restenosis.
We assessed the inflammatory response to elective coronary stent implantation (CSI) in stable diabetic and nondiabetic patients.
C-reactive protein (CRP), soluble (s) P-selectin, and soluble intercellular adhesion molecule (sICAM)-1 plasma levels were determined in diabetic (n = 51) and nondiabetic (n = 56) patients before and 48 hours and 4 weeks after bare metal stenting (BMS).
Diabetic patients presented significantly higher inflammatory marker levels before and after CSI. Nonetheless, diabetic and nondiabetic patients had postintervention peak of markers attained within 48 hours. At baseline, diabetic and nondiabetic patients presented CRP levels of 5.0 +/- 20.1 (P < or = 0.04) and 3.8 +/- 9.4 microg/ml and, at 48 hours postintervention, 22.0 +/- 20.2 (P = 0.001; P = 0.002) and 12.6 +/- 11.3 (P < or = 0.0001) microg/ml. Regarding sP-selectin, diabetic and nondiabetic patients obtained levels of, at baseline, 182 +/- 118 (P < or = 0.04) and 105 +/- 48 ng/ml and, at 48 hours, 455 +/- 290 (P = 0.001; P < or = 0.01) and 215 +/- 120 (P < or = 0.04) ng/ml. For diabetic and nondiabetic patients, sICAM-1 levels were, at baseline, 248 +/- 98 (P < or = 0.04) and 199 +/- 94 ng/ml and, at 48 hours, 601 +/- 201 (P = 0.001; P < or = 0.01) and 283 +/- 220 (P = 0.001) ng/ml. At 4 weeks, for all patients, markers returned to preprocedural levels: versus before PCI: *P = 0.001, (section sign)P < or = 0.0001; versus nondiabetic patients: (#)P < or = 0.04, (paragraph sign)P = 0.002, (Upsilon)P < or = 0.01.
Diabetic and nondiabetic patients exhibited a temporal inflammatory response after an elective BMS. However, diabetic patients present higher preprocedural levels of CRP, sP-selectin, and sICAM-1 and reveal a further exacerbated inflammatory response after intervention. The differences in inflammatory response may have implications in restenosis within these two sets of patients.
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ABSTRACT: Bandpass sigma-delta modulators commonly employ switch-capacitor (SC) or continuous-time (CT) loop filters. SC sigma-delta modulator can provide robust performance, but at low center frequencies. Its CT counterpart is able to operate at much high frequency, but its performance is often impaired by low-Q CT loop filters and the need of frequency tuning. In this paper, an alternative approach is introduced. Bandpass sigma-delta modulators employing electromechanical resonators as loop filter are described. As a proof-of-concept, a second- and fourth-order bandpass sigma-delta modulator are demonstrated in a 0.35-μm CMOS process using off-chip SAW resonators with a resonant frequency of 47.3 MHz. The dynamic ranges, measured in a 200-kHz signal bandwidth when sampled at 189.2 MHz, are 57 dB and 69 dB for the second- and fourth-order modulator, respectively. The chips operate under a 3.3-V single supply with a power dissipation of 30 and 45 mW, respectively.Radio-Frequency Integration Technology: Integrated Circuits for Wideband Communication and Wireless Sensor Networks, 2005. Proceedings. 2005 IEEE International Workshop on; 01/2005
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