ABSTRACT
Objective:To investigate the effects of preoperative ticagrelor application on postoperative NF-κB signa-ling pathway,platelet aggregation and myocardial microcirculatory perfusion in patients with acute myocardial in-farction(AMI)and multivessel lesions undergoing percutaneous coronary intervention(PCI).Methods:A total of 120 AMI patients with multivessel lesions treated in our hospital were selected,randomly and equally divided into clopidogrel group and ticagrelor group.Corresponding drugs were given in each group before and after PCI.NF-κB signaling pathway related indexes,platelet aggregation rate,myocardial microcirculatory indexes before and af-ter medication,and incidence of major adverse cardio-and cerebrovascular events(MACCE)were observed and compared between two groups.Results:On 7d after PCI,compared with clopidogrel group,there were significant reductions in corrected TIMI frame count(CTFC)of left anterior descending(LAD)[(23.83±2.69)vs.(20.48± 3.05)],left circumflex(LCX)[(20.93±2.82)vs.(18.35±2.37)]and right coronary artery(RCA)[(23.68± 3.15)vs.(21.13±2.79)]in ticagrelor group,P=0.001 all;compared with clopidogrel group after 30d treatment,there were significant reductions in platelet maximum aggregation rate,maximum depression amplitude of ST seg-ment,ST segment depression time,24h ischemia onset times,levels of Toll-like receptor 4(TLR4)protein,NF-κB protein,tumor necrosis factor(TNF)-a and interleukin(IL)-6 in ticagrelor group,P=0.001 all.There was no significant difference in incidence rate of MACE between two group within six months,P=0.186.Conclu-sion:Ticagrelor can improve myocardial microcirculation,inhibit platelet aggregation,and reduce inflammatory re-sponse in AMI patients with multivessel lesions,and the mechanism may be related to the inhibition of NF-κB sig-naling pathway activity by ticagrelor.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the effects on MACE of intracoronary or intravenous tirofiban bolus administration in patients with acute ST-elevation myocardial infarction (STEMI).</p><p><b>METHODS</b>A total of 60 consecutive STEMI patients ready to receive primary PCI were randomly assigned to intracoronary tirofiban bolus (10 microg/kg) prior to the first balloon inflation (Group IC) or to intravenous tirofiban bolus at the same dose prior to coronary angiography (Group IV), followed by a 36-hours IV tirofiban (0.15 microg . kg(-1) . min(-1)) infusion for all patients. Clinical and angiographic features between 2 groups before and after PCI were analyzed.</p><p><b>RESULTS</b>Fifty-four out of 60 STEMI patients accomplished the study. Group IC was superior to Group IV in terms of TIMI flow grade, TIMI myocardial perfusion grade, ST-segment resolution, the distal embolism of IRA immediately after PCI and ejection fraction at 5 - 7 days after the PCI. The in-hospital MACE rate and bleeding complications were similar between the groups while, the combined incidence of MACE during follow-up was significantly lower in the Group IC compared with Group IV (7.1% versus 30.8%; P = 0.02).</p><p><b>CONCLUSION</b>Intracoronary bolus application of tirofiban is associated with superior clinical prognosis compared with the standard intravenous bolus application of tirofiban in patients with STEMI undergoing primary PCI.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Angioplasty, Balloon, Coronary , Electrocardiography , Emergency Treatment , Follow-Up Studies , Infusions, Intravenous , Injections, Intra-Arterial , Myocardial Infarction , Therapeutics , Myocardial Reperfusion , Treatment Outcome , TyrosineABSTRACT
<p><b>OBJECTIVE</b>To study the correlation between morphological variation and gentiopicroside content in cultivated Gentiana manshurica roots and to investigate the feasibility of breeding new varieties of high effective constituent content.</p><p><b>METHOD</b>Gentiopicroside was determined in 5 morphological types of cultivated G. manshurica roots by HPLC, which are normal (or wild) type, white-flowered type, thick-rooted type, broad-leaved type I and broad-leaved type II.</p><p><b>RESULT</b>Among different types gentiopicroside content is the highest in the roots of thick-rooted type, the contents decrease as following order: normal type, broad-leaved type I white-flowered type and broad-leaved type II, and the gentiopicroside contents in the same type root system are a positive correlation with root ages, as 3-years-age roots > 2-years-age roots > 1-year-age varied with roots.</p><p><b>CONCLUSION</b>The contents of effective constituent vary with the morphological variation in cultivated G. manshurica. It is feasible to breed a new variety with high effective constituent with the morphological character as a selecting index.</p>