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1.
Heart Lung Circ ; 25(6): 600-6, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26726008

RESUMO

BACKGROUND: The aim of this study was to investigate the knowledge and understanding about hypertension among residents in Lhasa, Tibet. METHODS: A total of 1, 370 native Tibetan people aged ≥18 years old were enrolled in this survey. Individuals were selected using stratified proportional sampling and Lhasa was divided into Urban, Suburban, Agricultural and Pastoral areas. Data pertaining to blood pressure, socio-demographic details, knowledge and perceptions about hypertension were obtained. RESULTS: The prevalence of hypertension was highest among Urban participants (56.1%) and lowest among Pastoral participants (34.2%). The awareness of hypertension (43.1%) was lowest among Agricultural participants. Less than one third of the respondents knew the normal range of blood pressure. A considerable proportion (49.2%) had no idea of risk factors and consequences of hypertension. With regard to prevention and control, about 30% of the respondents did not know the lifestyle changes for hypertension prevention. Regarding treatment, 30% of participants did not provide an answer. Most of the respondents acquired knowledge of hypertension from healthcare providers. Participants from the Agricultural areas had the lowest knowledge of hypertension. Approximately 75.5% of hypertensive patients ceased antihypertensive medications on their own after improvement of blood pressure. CONCLUSIONS: The understanding of hypertension was poor among the native Tibetan people in Lhasa. There is a need to improve education and primary health care services to this large hypertensive population.


Assuntos
Hipertensão/epidemiologia , Conhecimento , Educação de Pacientes como Assunto , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Tibet/epidemiologia
2.
Heart Lung Circ ; 24(9): 885-90, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25837016

RESUMO

BACKGROUND: It is unclear whether intravenous proton pump inhibition is more effective than oral administration in preventing gastrointestinal (GI) bleeding in high bleeding risk patients with acute coronary syndromes (ACS). METHODS AND RESULTS: A total of 504 patients with ACS and high bleeding risk were randomly assigned into two groups. Study group (n=252) received intravenous pantoprazole for five days and subsequent oral pantoprazole for 12 months. Control group (n=252) received oral pantoprazole for 12 months. Major adverse cardiac events (death, re-infarction, re-revascularisation and stroke) and GI bleeding were registered after a follow-up of 12 months. No statistically significant differences were found in the major adverse cardiac events between the two groups after the follow-up (p >0.05). The incidence of major GI bleeding in the study group was lower than in the control group (1.2% vs. 3.9%, p=0.049). The bleeding rates in the first 30 days in the study group were also lower than in the control group (0.3% vs. 2.7%, p=0.032). CONCLUSIONS: The main outcome of cardiac events did not differ between the treatment groups. Intravenous plus oral pantoprazole therapy seemed more effective than oral therapy alone in the prevention of GI bleeding in high bleeding risk patients with ACS.


Assuntos
2-Piridinilmetilsulfinilbenzimidazóis/administração & dosagem , Síndrome Coronariana Aguda/tratamento farmacológico , Hemorragia Gastrointestinal/prevenção & controle , Administração Intravenosa , Administração Oral , Idoso , Humanos , Pessoa de Meia-Idade , Pantoprazol , Fatores de Risco
3.
Cardiology ; 128(4): 343-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24970296

RESUMO

OBJECTIVES: Recent studies have reported increased red blood cell distribution width (RDW) has been associated with adverse outcomes in heart failure and stable coronary disease. We investigated the association between RDW and risk of all-cause mortality in patients with ST-elevation myocardial infarction (STEMI) who were free of heart failure at baseline. METHODS: We enrolled 691 patients with STEMI who were free of heart failure at baseline confirmed by coronary angiography in Beijing Friendship Hospital from January 2007 to December 2008. According to the median RDW at baseline (13.0%) on admission, the patients were divided into two groups: a low-RDW group (RDW <13.0%, n = 329) and a high-RDW group (RDW ≥13.0%, n = 362). All-cause mortality rates were compared between groups. Mean duration of follow-up was 41.8 months. The relation between RDW and clinical outcomes after hospital discharge were tested using Cox regression models, adjusting for clinical variables. At the same time, the sensitivity and specificity of RDW were analyzed by ROC analysis. RESULTS: Forty-seven patients (6.8%) died during follow-up. The cumulative incidence of all-cause death was significantly higher in the high-RDW group than in the low-RDW group (log-rank p = 0.007). Multivariate analysis revealed that high RDW was associated with all-cause mortality (hazard ratio: 3.43; 95% confidence interval: 1.17-8.32; p = 0.025). The area under the ROC curve was 0.562. CONCLUSION: From the statistical point of view, increased RDW is associated with all-cause and cardiac mortality rates in patients with STEMI who were free of heart failure at baseline. But RDW is a marker with a very low prognostic accuracy that does not seem to be clinically helpful.


Assuntos
Índices de Eritrócitos , Infarto do Miocárdio/sangue , Infarto do Miocárdio/mortalidade , Idoso , Causas de Morte , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Risco
4.
Clin Exp Hypertens ; 36(1): 27-31, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23638647

RESUMO

OBJECTIVE: To investigate the association between anxiety disorders and left ventricular hypertrophy in patients with essential hypertension. METHODS: Left ventricular structure and function were assessed with echocardiography in 56 patients with essential hypertension and anxiety disorder (study group) and in 56 patients with hypertension only (control group). Serum adrenomedullin levels were also measured in these patients. RESULTS: There was no statistically significant difference in the left ventricular ejection fraction between the study and the control group (54.21 ± 88.81% versus 56.01 ± 7.85%, p>0.05). The left ventricular mass index (LVMI) in study group was higher than in control group (137.05 ± 9.42 versus 123.57 ± 7.01 g/m(2), p=0.001). The plasma levels of adrenomedullin in study group was higher than in control group (25.97 ± 5.48 versus 18.32 ± 6.97 ng/L, p=0.001). Levels of plasma adrenomedullin were positively correlated with LVMI in the study (r=0.734, p<0.05) and control group (r=0.592, p<0.05). CONCLUSION: Anxiety disorders are associated with elevated plasma adrenomedullin levels and increased left ventricular hypertrophy in patients with essential hypertension. The clinical significance of these changes requires further investigation.


Assuntos
Adrenomedulina/sangue , Transtornos de Ansiedade/sangue , Transtornos de Ansiedade/complicações , Hipertensão/sangue , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/sangue , Hipertrofia Ventricular Esquerda/complicações , Adulto , Idoso , Estudos de Casos e Controles , Hipertensão Essencial , Feminino , Ventrículos do Coração/diagnóstico por imagem , Humanos , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Ultrassonografia , Função Ventricular Esquerda , Adulto Jovem
5.
Heart Lung Circ ; 22(3): 184-7, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23177647

RESUMO

OBJECTIVE: The aim of this study was to evaluate the prognostic values of serum tenascin-C in patients with heart failure and ischaemic heart disease. METHODS: Serum tenascin-C levels were assessed in 83 patients with heart failure and in 30 healthy subjects. The correlations between serum tenascin-C levels and left ventricular ejection fraction, serum B-type natriuretic peptide and procollagen III were analysed. Patients were followed up for 12 months, and the relations between the serum levels of tenascin-C and cardiac events (re-hospitalisation for worsening heart failure and mortality) were analysed. RESULTS: Serum tenascin-C levels in patients with heart failure were higher than in healthy volunteers (72.24 ± 11.02 vs. 22.78 ± 2.51 µg/L, p<0.01). Serum tenascin-C levels in patients of NYHA class IV were higher than in patients with NYHA class II (88.56 ± 3.73 vs. 64.88 ± 3.15 µg/L, p<0.01). The levels of tenascin-C were negatively correlated with the left ventricular ejection fraction (r=-0.636, p<0.01), but were positively correlated with serum B-type natriuretic peptide (r=0.553, p<0.01) or procollagen III levels (r=0.665, p<0.01). An increased level of tenascin-C was an independent predictor for combined re-hospitalisation and mortality (OR 1.22, 95% CI: 0.86-2.14). CONCLUSION: Serum tenascin-C levels were elevated in patients with heart failure. The levels of tenascin-C were associated with the severity of left ventricular dysfunction and 12-month major adverse cardiac events.


Assuntos
Insuficiência Cardíaca/sangue , Tenascina/sangue , Idoso , Análise de Variância , Biomarcadores/sangue , Estudos de Casos e Controles , Colágeno Tipo III/sangue , Intervalos de Confiança , Progressão da Doença , Feminino , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/sangue , Isquemia Miocárdica/complicações , Peptídeo Natriurético Encefálico/sangue , Razão de Chances , Readmissão do Paciente , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Índice de Gravidade de Doença , Volume Sistólico , Disfunção Ventricular Esquerda/fisiopatologia
6.
Heart Lung Circ ; 22(6): 433-40, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23357095

RESUMO

OBJECTIVE: To evaluate the safety and efficacy of totally endoscopic repair of atrial septal defect (ASD). METHODS: A review of the literature was conducted. Studies were obtained from the following sources: MEDLINE, EMBASE, Web of Science and CENTRAL Library. Inclusion criteria were: (1) randomised controlled trials, non-randomised trials, observational studies, case series, and full text conference proceedings; (2) use of totally endoscopy closure of ASD; and (3) outcomes reported as clinical efficacy. When available, we also quantified the complication rates from each included study. Meta-analysis was performed on outcomes with a random-effects model. RESULTS: Six studies met all inclusion criteria. The pooled average success rate of totally endoscopic ASD repair was 94.8% from a total of 114 cases (95% CI, 88.0% to 97.8%), with a minimal heterogeneity in the group of studies (Q value x(2)=1.807, I(2)=0.000). In the studies with no robotic assistance, an average success rate of totally endoscopic ASD repair was 96.9% (95% CI, 85.9-99.4%), with a minimal heterogeneity in the two studies (Q value x(2)=0.683, I(2)=0.000). There were few complications for totally endoscopic ASD repair in the studies with and without robotic assistance. There were no statistically significant differences in success rates between robotically and non-robotically assisted totally endoscopic repairs (p>0.05). CONCLUSIONS: Totally endoscopic ASD repair was associated with a high success rate and a low complication rate. There is a need for prospective controlled clinical trials comparing totally endoscopic and conventional surgical repair of ASD.


Assuntos
Endoscopia/métodos , Comunicação Interatrial/terapia , Robótica/métodos , Ensaios Clínicos como Assunto , Feminino , Humanos , MEDLINE , Masculino
7.
Med Princ Pract ; 22(1): 24-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-22890443

RESUMO

OBJECTIVE: To evaluate the changes and the prognostic value of serum vascular endothelial growth factor (VEGF) in patients with differentiated thyroid cancer (DTC). SUBJECTS AND METHODS: A total of 79 patients with DTC and 30 healthy individuals were divided into four groups: (1) a healthy control group (n = 30); (2) DTC without recurrence (n = 35; 23 papillary, 12 follicular); (3) DTC with local recurrence (n = 24; 15 papillary, 9 follicular), and (4) DTC with lung metastasis (n = 20; 13 papillary, 7 follicular). Serum VEGF and thyroglobulin levels were measured in all patients. RESULTS: Serum levels of VEGF were significantly higher in the lung metastasis group than in the other three groups (p < 0.05). Serum thyroglobulin concentration positively correlated with VEGF expression (r = 0.8678, p < 0.001) in patients with thyroid cancer recurrence. Multivariate Cox regression analysis showed that clinical staging (OR = 1.851, 95% CI 1.04-3.47; p = 0.038), noncompliance with postoperative thyroxin replacement therapy (OR = 1.935, 95% CI 1.03-3.65; p = 0.042) and postoperative levels of thyroglobulin (OR = 1.892, 95% CI 1.01-3.56, p = 0.032) were independent predictors for thyroid cancer recurrence. Every additional 100 ng/l of serum VEGF levels increased the risk of thyroid cancer recurrence by 20.3%; but this did not reach statistical significance (OR = 1.203, 95% CI 0.95-1.52; p = 0.125). CONCLUSIONS: Serum VEGF increased in patients with recurrent thyroid cancer following surgical therapies. The predictive value of serum VEGF requires further investigation.


Assuntos
Neoplasias Pulmonares/secundário , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/patologia , Fator A de Crescimento do Endotélio Vascular/sangue , Adolescente , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/sangue , Prognóstico , Fatores de Risco , Fatores Sexuais , Tireoglobulina/sangue , Tiroxina/uso terapêutico , Adulto Jovem
8.
Exp Clin Cardiol ; 18(1): e40-3, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24294047

RESUMO

OBJECTIVE: To explore the effects of atorvastatin on the migration and adhesion of endothelial progenitor cells (EPCs) and on pulmonary artery pressure (PAP) in patients with chronic pulmonary heart disease. METHODS: A total of 68 patients with chronic pulmonary heart disease were randomly assigned to either a control group (n=35) or a treatment group (n=33). In addition, 30 healthy volunteers (17 male, 13 female) were enrolled as healthy controls. Atorvastatin (20 mg per day) was administered to the treatment group. The migration and adhesion activities of EPCs in peripheral blood were assessed before and six months after the treatment. PAP was measured using echocardiography before and after the treatment. RESULTS: EPC number, migration ability and adhesion activity in the peripheral blood of patients in the control and treatment groups were lower than in patients in the healthy control group at baseline (all P<0.05). After six months of atorvastatin therapy, the number of EPCs in the treatment group was greater than in the control group (P<0.05). Migration and adhesion functions of EPCs in the treatment group were greater than in the control group (all P<0.05). The reduction in PAP in the treatment group was greater than in the untreated control group following six months of therapy (P<0.05). CONCLUSION: Atorvastatin therapy increased the migration and adhesion activities of EPCs in patients with chronic pulmonary heart disease. Atorvastatin treatment was also associated with a reduction in PAP in these patients.

9.
Clin Exp Hypertens ; 34(5): 328-33, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22468789

RESUMO

To investigate the prevalence, self-awareness, and treatment of hypertension in Lhasa, Tibet, a total of 1370 native Tibetan aged ≥18 years were selected, using stratified proportional sampling. The study showed that the prevalence of hypertension was 51.2%, significantly higher in men (56.0%) than in women (48.0%) (P = .004). The hypertension prevalence increased with increasing age (77.8% in 60-74 y and 82.5% in ≥75 y groups) and was higher in urban, suburban, or agricultural area than in pastoral area (P < .001). The self-awareness, treatment, and control rate of hypertension were 63.5%, 24.3% and 7.7%, respectively. In multivariable regression analysis, age, urban residence, amount of daily intake of fat and oil, and body mass index <18.5 kg/m(2) were independently associated with hypertension. In conclusion, hypertension was highly prevalent among native Tibetan people in Lhasa, and the rates of self-awareness, treatment, and control of hypertension were low.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Hipertensão/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Etarismo , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/fisiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hipertensão/prevenção & controle , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Caracteres Sexuais , Tibet/epidemiologia , Adulto Jovem
10.
Acta Cardiol ; 67(5): 565-9, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23252007

RESUMO

OBJECTIVE: The efficacy of oral hydration in the prevention of contrast-induced nephropathy in patients undergoing elective coronary intervention is unclear. METHODS: A total of 120 patients were randomly assigned to three groups. Group A (n = 40) received intravenous hydration before and after coronary angiography or angioplasty. Group B (n = 40) received oral tap water before and after the procedures, whereas group C (n = 40) received only postprocedural drinking water. Levels of serum creatinine and urea nitrogen were measured before, 12 hours after, 2 and 3 days after the coronary angiography or angioplasty. RESULTS: : There was no statistically significant difference in the age, sex, baseline renal function and the volume of contrast medium used during the coronary procedures among the three groups (P > 0.05).There was no statistically significant difference in the mean serum creatinine or urea nitrogen among the three groups 12 hours, and 3 days after the coronary procedures ( P > 0.05).The incidence of contrast-induced nephropathy in group A, B and C was 5.0% (2/40), 7.5% (3/40) and 5.0% (2/40), respectively (P = 0.86). Renal function in the seven patients who experienced contrast-induced nephropathy recovered within a week following rehydration treatment. CONCLUSIONS: Pre- and post-procedural oral hydration was as effective as intravenous rehydration in the prevention of contrast-induced nephropathy in patients undergoing coronary angiography or angioplasty.


Assuntos
Angioplastia Coronária com Balão/efeitos adversos , Meios de Contraste/efeitos adversos , Angiografia Coronária/efeitos adversos , Água Potável/administração & dosagem , Hidratação/métodos , Soluções Isotônicas/administração & dosagem , Nefropatias/prevenção & controle , Administração Oral , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença das Coronárias/diagnóstico por imagem , Doença das Coronárias/terapia , Feminino , Seguimentos , Humanos , Infusões Intravenosas , Nefropatias/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
11.
Chin Med J (Engl) ; 132(9): 1045-1052, 2019 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-30896567

RESUMO

BACKGROUND: Depression and anxiety have been correlated with elevated risks for quality-of-life (QOL), adverse outcomes, and medical expenditure in patients with acute coronary syndrome (ACS). However, the relevant data are lacking for Chinese ACS populations, especially regarding different effects of major depression, anxiety, and comorbidity. The objective of this study was to evaluate the dynamic changes of depression and/or anxiety over 12 months and examine the effects of depression, anxiety, and comorbidity on QOL, adverse outcomes, and medical expenditure in Chinese patients with ACS. METHODS: For this prospective longitudinal study, a total of 647 patients with ACS were recruited from North China between January 2013 and June 2015. Among them, 531 patients (82.1%) completed 12-month follow-ups. Logistic regression model was utilized for analyzing the association of baseline major depression, anxiety, and comorbidity with 12-month all-cause mortality, cardiovascular events, QOL, and health expenditure. RESULTS: During a follow-up period of 12 months, 7.3% experienced non-fatal myocardial infarction (MI) and 35.8% cardiac re-hospitalization. Baseline comorbidity, rather than major depression/anxiety, strongly predicted poor 12-month QOL as measured by short-form health survey-12 (odds ratio [OR]: 1.77, 95% confidence interval [CI]: 1.22-2.52, P = 0.003). Regarding 12-month non-fatal MI and cardiac re-hospitalization, baseline anxiety (OR: 2.83, 95% CI: 1.33-5.89, P < 0.01; OR: 4.47, 95% CI: 1.50-13.00, P < 0.01), major depression (OR: 2.58, 95% CI: 1.02-6.15, P < 0.05; OR: 5.22, 95% CI: 1.42-17.57, P < 0.03), and comorbidity (OR: 6.33, 95% CI: 2.96-13.79, P < 0.0001, OR: 14.08, 95% CI: 4.99-41.66, P < 0.0001) were all independent predictors, and comorbidity had the highest predictive value. Number of re-hospitalization stay, admission frequency within 12 months and medical expenditure within 2 months were the highest in patients with ACS with comorbidity. CONCLUSIONS: Major depression and anxiety may predict 12-month non-fatal MI and cardiac re-hospitalization. However, comorbidity has the highest predictive value with greater medical expenditure and worse QOL in Chinese patients with ACS. And depression with comorbid anxiety may be a new target of mood status in patients with ACS.


Assuntos
Ansiedade/fisiopatologia , Depressão/fisiopatologia , Infarto do Miocárdio/fisiopatologia , Síndrome Coronariana Aguda/economia , Síndrome Coronariana Aguda/fisiopatologia , Idoso , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/economia , Estudos Prospectivos , Qualidade de Vida
12.
J Biomed Res ; 2018 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-30249813

RESUMO

Multivessel coronary artery ectasia with severe calcification is rare among patients with coronary artery disease. A 74-year-old Chinese woman suffered from acute myocardial infarction on a background of 50 years of poorly controlled hypertension secondary to pheochromocytoma, which was surgically removed in June 2012 prior to the presentation. Coronary angiography revealed total occlusion of the proximal left anterior descending artery, and multiple ectasias with severe calcification in the left main, circumflex and right coronary artery. After an aspiration thrombectomy and balloon angioplasty, grade 3 coronary flow was restored in the left descending coronary artery. No cardiac events were found in the 12-month follow-up. We conclude that multivessel coronary artery ectasia and severe calcification may be present in patients with a long-standing history of hypertension secondary to pheochromocytoma.

13.
Zhonghua Xin Xue Guan Bing Za Zhi ; 34(5): 450-3, 2006 May.
Artigo em Zh | MEDLINE | ID: mdl-16776965

RESUMO

OBJECTIVE: To assess the effect of valsartan eluting-stents on restenosis and collagen deposition in neointima hyperplasia in rabbits. METHODS: Valsartan eluting-stents and the carrier eluting-stents were made with patented multi-layers coating techniques. Bare stents (n = 8), carrier eluting-stents (n = 8) and valsartan eluting-stents (n = 10) were implanted into rabbit abdominal aortas, respectively. Quantitive angiography (QA) was performed before, immediately post and 3 months after stents implantations to determine the diameter of aortas. Rabbits were killed 3 months post stents implantation and the cross sections of the stented vessels were analyzed for neointimal formation: luminal area (LA), neointimal area (NIA), inner elastic lumina area (IELA), the maximal inner-membrane thickness (MIT) and percent stenosis. MASSON and picrosirius red staining were performed to observe the collagen deposition in neointima analyzed. RESULTS: The mean aortic diameters measured by QA at different time points were similar between the groups. LA was significantly larger (5 016 269 microm(2) +/- 207,934 microm(2) vs. 4,345,548 microm(2) +/- 125,822 microm(2) and 4,302,061 microm(2) +/- 167,952 microm(2), P < 0.01 vs. valsartan stents) while NIA (441,577 microm(2) +/- 74,099 microm(2) vs. 1,119,635 microm(2) +/- 163,503 microm(2) and 1,135,636 microm(2) +/- 136,555 microm(2)) and MIT (116 microm +/- 12 microm vs. 240 microm +/- 30 microm and 192 microm +/- 21 microm) as well as percent stenosis (8% +/- 2% vs. 20% +/- 2% and 21% +/- 2%) were significantly reduced in valsartan eluting-stents group compared to bare and carrier stents groups. MASSON and picrosirius red staining revealed rich type III collagen deposition in neointima and spare type I collagen patched around stents struts in bare and carrier stents groups and collagen deposition was rarely seen in neointima and stents struts in valsartan eluting-stents group. CONCLUSION: Valsartan eluting-stents inhibited neointimal hyperplasia by decreasing collagen deposition.


Assuntos
Colágeno/metabolismo , Reestenose Coronária/terapia , Oclusão de Enxerto Vascular/patologia , Tetrazóis/uso terapêutico , Valina/análogos & derivados , Animais , Reestenose Coronária/metabolismo , Reestenose Coronária/patologia , Vasos Coronários/patologia , Stents Farmacológicos , Feminino , Oclusão de Enxerto Vascular/metabolismo , Hiperplasia , Masculino , Coelhos , Túnica Íntima/patologia , Valina/uso terapêutico , Valsartana
14.
Chin Med J (Engl) ; 129(7): 804-8, 2016 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-26996475

RESUMO

BACKGROUND: Coronary artery disease (CAD) is a leading cause of morbidity and mortality in patients with connective tissue diseases (CTDs). Risk factors and clinical characteristics in these patients are not equivalent to those in traditional CAD patients. The objective of this study was to report short- and long-term clinical outcomes in a consecutive series of patients with CTD who underwent percutaneous coronary intervention (PCI) with stent implantation. METHODS: The study group comprised 106 consecutive patients with CTD who underwent PCI in Beijing Friendship Hospital between January 2009 and June 2012. Medical records were analyzed retrospectively including clinical basic material, coronary angiogram data, and the incidence of major adverse cardiac events (MACEs) during the short- and long-term (median 3 years) follow-up. RESULTS: Ninety-two of the patients (86.8%) had one or more traditional CAD risk factors. Multivessel disease was present in more than 2/3 of patients (73.6%). The left anterior descending coronary artery was the most commonly affected vessel (65.1%). Five bare-metal stents and 202 drug-eluting stents were implanted. After a median follow-up period of 36 months, thirteen patients (12.3%) died from cardiac causes, the rate of stent thrombosis was 9.4%, and the rate of target vessel revascularization (TVR) was 14.2%. Multivariate analysis revealed that hypertension (hazard ratio [HR] = 3.07, 95% confidence interval [CI]: 1.30-7.24, P = 0.041), anterior myocardial infarction (HR = 2.77, 95% CI: 1.06-7.03, P = 0.04), longer duration of steroid treatment (HR = 3.60, 95% CI: 1.43-9.08, P = 0.032), and C-reactive protein level >10 mg/L (HR = 3.98, 95% CI: 1.19-12.56, P = 0.036) were independent predictors of MACEs. CONCLUSIONS: Patients with CTD and CAD may have severe coronary lesions. PCI in these patients tends to result in an increased rate of stent thrombosis and TVR during long-term follow-up, which may be influenced by traditional and nontraditional risk factors.


Assuntos
Doenças do Tecido Conjuntivo/complicações , Intervenção Coronária Percutânea , Idoso , Proteína C-Reativa/análise , Angiografia Coronária , Stents Farmacológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
15.
Exp Ther Med ; 6(1): 121-124, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23935732

RESUMO

The aim of this study was to evaluate the correlation between levels of serum high-mobility group box-1 (HMGB1) and high-sensitivity C-reactive protein (hs-CRP) and cardiac troponin I in patients with coronary artery disease. The levels of serum HMGB1, hs-CRP and cardiac troponin I were measured in 98 patients with coronary artery disease and in 30 healthy subjects. The correlation between serum HMGB1 levels and hs-CRP and cardiac troponin I levels was analyzed. Serum HMGB1 levels in patients with coronary artery disease were higher compared with those in healthy volunteers (63.5±15.29 vs. 21.98±4.33 µg/l; P<0.01). Serum HMGB1 levels in patients with acute myocardial infarction were higher compared with those in patients with unstable and stable angina pectoris (77.53±6.86 vs. 63.67±8.6 and 44.39±9.01 µg/l, respectively; both P<0.01). The levels of HMGB1 were positively correlated with hs-CRP and cardiac troponin I levels (r=0.657 and 0.554, respectively; both P<0.01) in patients with coronary artery disease. In conclusion, serum HMGB1 levels were elevated in patients with coronary artery disease, particularly in those with acute myocardial infarction. The levels of HMGB1 were correlated with the levels of hs-CRP and cardiac troponin I.

16.
J Cardiovasc Pharmacol Ther ; 17(3): 303-7, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22203134

RESUMO

OBJECTIVE: To evaluate the therapeutic effects of prostaglandin E(1) (PGE(1)) on residual pulmonary arterial hypertension (PAH) after corrective surgery for congenital heart disease. METHODS: Thirty-one patients with postoperational PAH were randomly divided into control group (n = 15) and PGE(1) group (n = 16, 6 courses of intravenous PGE(1) plus conventional therapy). Mean pulmonary arterial pressure (MPAP), right ventricular ejection fraction (RVEF), and left ventricular ejection fraction (LVEF) were measured by echocardiography before and 3, 6, and 12 months after the treatment. Arterial oxygen pressure (Pao (2)) was monitored. RESULTS: In both groups, MPAP decreased and RVEF, LVEF, and Pao (2) increased at 6 and 12 months following surgery. In the PGE(1) group, the MPAP (32.2 ± 5.2 vs 40.2 ± 5.1 mm Hg; P = .008) was lower and RVEF (66.6% ± 6.5% vs 54.9% ± 2.1%; P = .019), LVEF (65.9% ± 3.9% vs 53.5% ± 5.1%; P = .031), and Pao (2) (94.3% ± 11.2% vs 93.1% ± 11.3%; P = .009) was higher than in the control group 12 months after the surgery. Four patients (26.7%) in the control group died of pulmonary hypertension crisis, but there was no death in the PGE(1) group (P = .029). Cumulative survival rate in the control group were 86.7%, 80%, 73.3%, and 73.3% at 1, 2, 3, and 5 years, respectively. CONCLUSIONS: Intravenous PGE(1) therapy after corrective surgery for congenital heart disease was associated with a reduction in mean pulmonary arterial pressure and a lower risk of death.


Assuntos
Alprostadil/uso terapêutico , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Cardiopatias Congênitas/cirurgia , Hipertensão Pulmonar/tratamento farmacológico , Vasodilatadores/uso terapêutico , Adolescente , Adulto , Hipertensão Pulmonar Primária Familiar , Feminino , Humanos , Hipertensão Pulmonar/etiologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
18.
Congest Heart Fail ; 17(3): 152-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21609390

RESUMO

More than 50% of patients with heart failure die from sudden cardiac death as a result of malignant arrhythmia. T wave alternans (TWA) is a convenient, noninvasive, and inexpensive testing modality, with a higher sensitivity and specificity for sudden cardiac death. Its prediction value for malignant arrhythmia may even exceed electrophysiologic study. Generally, the algorithms of TWA can be divided into frequency-domain and time-domain methods, and the latter has a stronger anti-interference ability. So far, a unified measuring formula and diagnostic criteria about TWA measurements have been created. Large clinical studies in recent years strongly suggest that TWA can predict sudden cardiac death, which can be used as a guide for the implanting of implantable cardioverter-defibrillator. This article reviews the current literature on recording techniques and clinical implications of TWA.


Assuntos
Morte Súbita Cardíaca/prevenção & controle , Técnicas Eletrofisiológicas Cardíacas , Insuficiência Cardíaca/diagnóstico , Arritmias Cardíacas/diagnóstico , Doença Crônica , Eletrocardiografia , Humanos , Valor Preditivo dos Testes
19.
J Geriatr Cardiol ; 8(2): 88-92, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22783291

RESUMO

BACKGROUND: To document the pharmacotherapy of chronic heart failure (CHF) and to evaluate the adherence to treatment guidelines in Australian population. METHODS: The pharmacological management of 677 patients (female 46.7%, 75.5 ± 11.6 years) with CHF was retrospectively analyzed. RESULTS: The use of angiotensin converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARB) and ß-blockers were 58.2 % and 34.7 %, respectively. Major reasons for non-use of ACE inhibitors/ARBs were hyperkalemia and elevated serum creatinine level. For patients who did not receive ß-blockers, asthma and chronic obstructive pulmonary disease were the main contraindications. Treatment at or above target dosages for ACE inhibitors/ARBs and ß-blockers was low for each medication (40.3% and 28.9%, respectively). CONCLUSIONS: Evidenced-based medical therapies for heart failure were under used in a rural patient population. Further studies are required to develop processes to improve the optimal use of heart failure medications.

20.
Thromb Res ; 128(5): e91-4, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21813162

RESUMO

INTRODUCTION: This study was designed to evaluate safety and efficacy of combined low dose aspirin and warfarin therapy following mechanical heart valve replacement. METHODS: A total of 1496 patients (686 males, mean age 35±8.5 years) undergoing mechanical heart valvular replacement were randomly divided into study (warfarin plus 75-100 mg aspirin) or control (warfarin only) group. International normalized ratio (INR) and prothrombin time was maintained at 1.8-2.5 and 1.5-2.0 times of the normal value, respectively. Thromboembolic events and major bleedings were registered during follow up. RESULTS: Patients were followed up for 24±9 months. The average dose of warfarin in the study and control group was 2.92±0.87 mg and 2.89±0.79 mg, respectively (p>0.05). The overall thromboembolic events in study group were lower than in control group (2.1% vs. 3.6%, p=0.044). No statistically significant differences were found in hemorrhage events (3.5% vs. 3.7%, p>0.05) or mortality (0.3% vs 0.4%, p>0.05) between the two groups. CONCLUSIONS: Following mechanical valve replacement, combined low dose aspirin and warfarin therapy was associated with a greater reduction in thromboembolism events than warfarin therapy alone. This combined treatment was not associated with an increase in the rate of major bleeding or mortality.


Assuntos
Anticoagulantes/uso terapêutico , Implante de Prótese de Valva Cardíaca/efeitos adversos , Adulto , Anticoagulantes/administração & dosagem , Aspirina/administração & dosagem , Aspirina/uso terapêutico , Quimioterapia Combinada , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Feminino , Hemorragia/tratamento farmacológico , Hemorragia/prevenção & controle , Humanos , Coeficiente Internacional Normatizado , Masculino , Tempo de Protrombina , Tromboembolia/tratamento farmacológico , Tromboembolia/prevenção & controle , Resultado do Tratamento , Varfarina/administração & dosagem , Varfarina/uso terapêutico , Adulto Jovem
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