In this way, our selleck chemical Enzastaurin present finding strengthens that of our recent study. Of particular importance was that this gene ex pression in PBMNCs was significantly attenuated by day 90 after clopidogrel and cilostazol combination therapy. Based on the present study, we postulate that galectin 3 and Lp PLA2 mRNA may also be valuable biomarkers for assessing acute and chronic inflammatory changes. A body of previous studies have shown that ROCK sig naling pathway mediates in the sustained vasoconstric tion, smooth muscle proliferation, vascular remodeling, hypertension and inflammatory reaction and participates in down regulation and inhibition of endo thelial nitric oxide synthase. Addition ally, abundant evidences have revealed that peripheral leukocyte ROCK activity is an useful biomarker for pre dictive of co morbidity of cardiovascular disease and long term mortality in patients with cardiovascular dis ease.
Inhibitors,Modulators,Libraries In the present study, as compared with the baseline, our results reveal that the protein expressions of RhoA and Tac were remarkably reversed whereas the total MLC and phos phorylated MLC, and the ratio of phosphorylated MLC to total MLC were sub stantially attenuated on day 90 after clopidogrel and cilostazol combination therapy. These findings imply that combination therapy may have reduced the pro inflammatory effect of WBCs despite no change in WBC counts between days 0 and 90 of study period. Clinical observational study have previously demon strated that the 1 year mortality rate can be as high as 25% for CLI patients without appropriate treatment.
Inhibitors,Modulators,Libraries The most important finding in the present study was that besides marked suppression on inflammatory bio markers, Inhibitors,Modulators,Libraries the clinical outcome of our patients with high grade CLI without surgical or endovascular intervention was notably Inhibitors,Modulators,Libraries improved after clopidogrel and cilostazol combination therapy. Additionally, the blood sugar, HbA1c, total cholesterol level and LDL were also mark edly reduced on day 90. Therefore, we suggest that the 90 day clinical improvement in CLI patients could be due to not only the effect of combination therapy but was also due to the well control of traditional CAD risk factors. The COURAGE Trial Inhibitors,Modulators,Libraries has emphasized the clinical outcome of optimal medical therapy without per cutaneous coronary intervention in patients with stable coronary artery disease is similar to those underwent PCI on long term follow up.
The results from Courage study may support the findings of our may study. There fore, in view of the previous study outcomes, the re sults of the present study encourage the use of clopidogrel and cilostazol combination therapy for those CLI pa tients who are not the candidate for surgical or endovas cular intervention. The exact mechanisms of clopidogrel and cilostazol combination therapy in CLI remain unclear. We propose that three effects might be generated.