Marco Antonio Martínez-Ríos

Background. The molecular mechanisms underlying acute coronary syndrome (ACS) have been extensively investigated, with a particular focus on the role of circulating microvesicles (MVs) as carriers of regulatory elements that influence hemodynamic changes and coronary flow. Endothelial and platelet dysfunction during ACS alters MV composition, impacting clinical outcomes. This study explores the levels of miR–126–5p and miR–223–3p in circulating MVs and their association with the Thrombolysis in Myocardial Infarction (TIMI) coronary flow classification scale, proposing their potential as biomarkers. Methods. Bioinformatic tools identified miRNAs linked to ACS. Plasma MVs were isolated from ACS patients and healthy controls through high-speed centrifugation. miRNA levels were quantified using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and compared across TIMI 0 and TIMI 3 groups. Diagnostic efficacy was assessed via receiver operating characteristic (ROC) curve analysis. Results. The bioinformatic analysis identified miR–126 and miR–223 present in ACS. miR–126–5p and miR–223–3p were significantly reduced in MVs from TIMI 0 patients compared to TIMI 3. ROC analysis showed high diagnostic accuracy for miR–126–5p (AUC = 0.918; 95% CI: 0.818–1.00; p = 0.001) and miR–223–3p (AUC = 1.00; 95% CI: 1.00–1.00; p < 0.001). Conclusions. Reduced levels of miR–126–5p and miR–223–3p in circulating MVs are strongly associated with impaired coronary flow, positioning these miRNAs as potential biomarkers for ACS risk stratification and therapeutic targeting.

Background: The molecular mechanisms underlying acute coronary syndrome (ACS) have been extensively investigated, with a particular focus on the role of circulating microvesicles (MVs) as carriers of regulatory elements that influence hemodynamic changes and coronary flow. Endo-thelial and platelet dysfunction during ACS alters MVs composition, impacting clinical outcomes. This study explores the levels of miR–126–5p and miR–223–3p in circulating MVs and their asso-ciation with the Thrombolysis in Myocardial Infarction (TIMI) coronary flow classification scale, proposing their potential as biomarkers. Methods. Bioinformatic tools identified miRNAs linked to ACS. Plasma MVs were isolated from ACS patients and healthy controls through high-speed centrifugation. miRNA levels were quantified using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and compared across TIMI 0 and TIMI 3 groups. Diagnostic efficacy was assessed via receiver operating characteristic (ROC) curve analysis. Results. The bioinformatic analysis identified miR–126 and miR–223 present in ACS. miR–126–5p and miR–223–3p were sig-nificantly reduced in MVs from TIMI 0 patients compared to TIMI 3. ROC analysis showed high diagnostic accuracy for miR–126–5p (AUC = 0.918; 95% CI: 0.818–1.00; p = 0.001) and miR–223–3p (AUC = 1.00; 95% CI: 1.00–1.00; p < 0.001). Conclusion. Reduced levels of miR–126–5p and miR–223–3p in circulating MVs are strongly associated with impaired coronary flow, positioning these miRNAs as potential biomarkers for ACS risk stratification and therapeutic targeting.

Introducción: La insuficiencia cardiaca crónica (ICC) es una enfermedad que reduce de manera aguda y progresiva la funcionalidad física. El paciente comúnmente sufre de recaídas intermitentes que aumentan la probabilidad de comorbilidades como insomnio crónico, deterioro cognitivo, alteraciones en la respuesta sexual, estrés psicológico, síntomas de trastorno de ansiedad y depresión y disminución de las conductas de autocuidado. Objetivo: Identificar las principales necesidades de apoyo psicológico en pacientes con IC. Metodología: Se realizó un estudio descriptivo, transversal y analítico. Se evaluaron 150 pacientes con ICC del Centro Especializado en Insuficiencia Cardiaca del Instituto Nacional de Cardiología Ignacio Chávez de noviembre de 2018 a abril de 2019. Se aplicaron los inventarios: Calidad de vida en pacientes con IC (Minnesota), Escala de Ansiedad y Depresión Hospitalaria (HADS), termómetro del distrés psicológico (escala analógica visual) y el Inventario de Necesidades de Información del Paciente con IC. Resultados: Treinta y tres por ciento de los pacientes perciben un nivel alto de distrés psicológico que requiere asistencia inmediata y el 26.6% reporta un nivel medio que requiere monitoreo. Las principales necesidades de información reportadas por los pacientes fueron información sobre la toma de medicamentos (53.7%) y manejo del estrés psicológico (43.9%). Conclusión: En pacientes con IC es relevante la valoración activa de distrés psicológico y necesidades de información no cubiertas, resaltando de este modo la importancia de su identificación y el correcto diseño y aplicación de intervenciones basadas en la evidencia enfocadas a su resolución.

We evaluated whether CETP and LCAT gene polymorphisms are statistically associated with the high‐density lipoprotein (HDL) size distribution, the cholesterol level of HDL subclasses, and the acute coronary syndrome (ACS) susceptibility. Two CETP gene polymorphisms (rs4783961 and rs708272) and one LCAT polymorphism (rs2292318) were genotyped by 5′ exonuclease TaqMan assays in 619 patients with ACS and 607 control individuals. For HDL analysis, a subgroup of 100 healthy individuals was recruited; the HDL subclasses were separated via ultracentrifugation and polyacrylamide gradient gel electrophoresis under native conditions. Under a dominant model, the G allele of the rs708272 polymorphism was associated with an increased risk of ACS (odds ratios [OR] = 1.45, corrected p‐value [pC_Dom] = 0.036). The linkage disequilibrium analysis showed that one of the eight possible combinations was associated with the risk of developing ACS (OR = 1.52, pC = 0.02), which suggests that it may contribute to coronary atherosclerosis. The rs708272 G allele carriers had a lower concentration of cholesterol associated with the HDL2a and HDL3a subclasses when compared with subjects carrying the A allele. Carriers of LCAT rs2292318 A allele showed a lower concentration of high‐density lipoprotein‐cholesterol (HDL‐C) in comparison to the GG genotype; the cholesterol associated with the each one of the five HDL subclasses was significantly lower in rs2292318 A than in GG subjects. In summary, this study demonstrates that the rs708272 polymorphism is associated with a heightened risk of developing ACS. In addition, we report the association of the rs708272 and rs2292318 polymorphisms with HDL‐C levels and HDL subclasses.

Acute pulmonary embolism is one of the main causes of death, morbidity and hospitalisation [1, 2]. The most common cause of early death in these patients is right ventricular failure [1–3]. Complete resolution of the pulmonary thrombus at 6 months of evolution is not achieved in 57% of patients, with persistent right ventricular dysfunction (RVD) in 6–8% of patients and persistent pulmonary arterial hypertension (PAH) in 7–13.5% of patients who received treatment with heparin or fibrinolytic agents [4–8]. Percutaneous mechanical thrombectomy (PMT) is accepted as a treatment in patients with high-risk acute pulmonary embolism with contraindications to systemic thrombolysis or when the treatment has failed [1, 2, 9]. Percutaneous mechanical thrombectomy in acute PE restores right ventricle function in most patients at 40 months