ABSTRACT
Objective To investigate the anti-oxidative effects of alprostadil on contrast-induced nephropathy(CIN)after percuteous coronary intervention (PCI)in patients with chronic kidney disease(CKD).Methods A total of 200 patients with CKD were enrolled in our hospital.According to the random number table was divided into alprostadil 100 cases,100 cases of conventional treatment group.The levels of serum creatinine (Scr),creatinine clearance (eGFR),serum cystatin C (ScysC)and 8-hydroxy-deoxyguanine (8-OHdG)were observed before and after operation at 72 h and 7 d after operation.Results The incidence of CIN in the alprostadil group was significantly lower than that in the conventional treatment group (6% vs 12%,P<0.05).There was no significant difference in the level of Scr,eGFR,ScysC and 8-OHdG between the alprostadil group and the conventional treatment group (P>0.05).The level of Scr in the alprostadil group was significantly lower than that in the conventional treatment group at 72 h and 7 d after operation.The level of eGFR was significantly higher than that of the conventional treatment group (P<0.05).The levels of ScysC and 8-OHdG in the two groups were significantly higher than those before operation at 72 h and 7 d(P>0.05).The levels of ScysC and 8-OHdG in the alprostadil group were significantly lower than those in the conventional treatment group at 72 h and 7 d after PCI(P<0.05).Conclusion Alprostadil may improve the oxidative stress in patients with CKD and provide a preventive effect on CIN.
ABSTRACT
Objective To study the CYP2C19 genotype in patients with acute coronary syndrome(ACS) complicated with diabetes mellitus(DM)receiving percutaneous coronary intervension(PCI)by polymerase chain reaction(PCR),and to evaluate the efficacy of Ticagrelor in CYP2C19 gene polymorphism. Methods A total of 494 ACS patients with DM were enrolled. The patients were divided into routine treatment group and individual treatment group. Routine treatment group received 0.1 g/d aspirin/d and 75 mg/d of Clopidogrel. CYP2C19 gene polymorphism was examined in individual treatment group.(*1/*1)was classified into fast metabolic type,mutant heterozygous type(*1/*2,*1/*3)into intermediate metabolic type and mutant pure type (*2/*2,*2/*3,*3/*3) into slow metabolic type. Fast metabolic type received aspirin 0.1 g/d and Clopidogrel 75 mg/d,and intermediate and slow metabolic type received aspirin 0.1 g/d and Ticagrelor 90 mg bid for 12 months or more to observe the inci-dence of adverse cardiovascular events ,bleeding and other adverse reactions in 2 groups. Results The incidence of cardiac death ,recurrent myocardial infarction and angina pectoris ,stroke ,stent thrombosis and target vessel revascularization in routine treatment group was significantly higher than that in individual treatment group(P <0.05). There was no significant difference between two groups in terms of major bleeding and secondary bleeding (P > 0.05). The minimum bleeding rate was slightly higher in intermediate metabolic type in individual treatment group but without significantly difference when compared with that in fast metabolic type and slow metabolic type (both P>0.05). Conclusion Without elevating the risk of bleeding within 12 months,the efficacy of Ticagrelor is not affected by CYP2C19 gene polymorphism in patients with ACS complicated with DM after PCI.
ABSTRACT
Objective To study the CYP2C19 genotype in patients with acute coronary syndrome(ACS) complicated with diabetes mellitus(DM)receiving percutaneous coronary intervension(PCI)by polymerase chain reaction(PCR),and to evaluate the efficacy of Ticagrelor in CYP2C19 gene polymorphism. Methods A total of 494 ACS patients with DM were enrolled. The patients were divided into routine treatment group and individual treatment group. Routine treatment group received 0.1 g/d aspirin/d and 75 mg/d of Clopidogrel. CYP2C19 gene polymorphism was examined in individual treatment group.(*1/*1)was classified into fast metabolic type,mutant heterozygous type(*1/*2,*1/*3)into intermediate metabolic type and mutant pure type (*2/*2,*2/*3,*3/*3) into slow metabolic type. Fast metabolic type received aspirin 0.1 g/d and Clopidogrel 75 mg/d,and intermediate and slow metabolic type received aspirin 0.1 g/d and Ticagrelor 90 mg bid for 12 months or more to observe the inci-dence of adverse cardiovascular events ,bleeding and other adverse reactions in 2 groups. Results The incidence of cardiac death ,recurrent myocardial infarction and angina pectoris ,stroke ,stent thrombosis and target vessel revascularization in routine treatment group was significantly higher than that in individual treatment group(P <0.05). There was no significant difference between two groups in terms of major bleeding and secondary bleeding (P > 0.05). The minimum bleeding rate was slightly higher in intermediate metabolic type in individual treatment group but without significantly difference when compared with that in fast metabolic type and slow metabolic type (both P>0.05). Conclusion Without elevating the risk of bleeding within 12 months,the efficacy of Ticagrelor is not affected by CYP2C19 gene polymorphism in patients with ACS complicated with DM after PCI.
ABSTRACT
Objective To investigate the correlation between morning blood pressure surge and Coronary Microvascular Dysfunction.Methods 58 cases of patients with hypertension in our hospital were given 24 h ambu-latory blood pressure monitoring(ambulatory blood pressure monitoring,ABPM).The coronary microvascular dys-function was estimated by the index of microcirculatory resistance(IMR). All cases were given biochemical test-ing,included TCH,TG,HDL-c,LDL-c and SUA.Results According to whether ABMP was arise,the patient were divided into MBPS group(n=21)and the Non-MBPS group(n=37).24 h,day,night and morning peak of systolic blood pressure were significantly higher in the morning peak group than in the average morning peak group. Multiple linear regression analysis showed that,MBPS,24 h average systolic blood pressure,day average systolic blood pressure,night average systolic blood pressure,and age were independent risk factors for coronary artery disease.Conclusion Morning blood pressure surge is closely related to severity of coronary microcirculation dysfunction. It is an independent risk factor for coronary microcirculation dysfunction. To control the blood pres-sure in patients with hypertension effectively can reduce morning peak target organ damage.
ABSTRACT
Objective To compare the changes of plasma lipid indexes and coronary artery atherosclerotic plaque in TaqI B genotypes in CHD patients with impaired glucose tolerance (IGT) before and after statin therapy. Methods A total of 196 CHD with IGT and 160 controls were included. The changes of plasma lipid indexes and coronary artery atherosclerotic plaque in TaqI B genotypes were analyzed before and after Rosovastatin therapy. Sequenom Mass ARRAY platform was used to detect the CETP TaqI B SNPs. Results The genotype frequency of the B1B1, B1B2 and B2B2 in CHD with IGT group was 35.7%, 48.0% and 16.3% respectively, while in control group was 31.3%, 53.1% and 15.6% respectively. HDL-C, PA and MLA levels increased after Rosuvastatin therapy, while LDL-C, TG, TCH, Lpa, PA, EEMA and PB levels decreased. Conclusions CETP gene polymorphisms TaqI B would have association with the effects of Rosuvastatin therapy in the CHD with IGT.
ABSTRACT
Objective To investigate the efficacy and safety of cool-tipped saline-irrigated catheter ablation of epicardial accesso-ry pathway in the patients after failure of conventional radiofrequency ablation .Methods 30 patients with epicardial accessory path-way after failuer of conventional radiofrequency ablation were included in this study ,among them ,25 cases of the left accessory pathway and 5 cases of the right accessory prathway used the cool-tipped catheter for conducting ablation through the endocardium (ventricular side or atrial side) or coronary sinus .Results All patients achieved success ,no intraoperative and postoperative related complications occurred .Conclusion The cool-tipped saline-irrigated catheter ablation of epicardial accessory pathway is effective and safe in the patients after failure of conventional radiofrequency ablation ,which may improve the success rate of epicardial acces-sory pathway ablation .
ABSTRACT
Objective To study the characteristics and clinical significance of the coronary plaques in patients with benign prostatic hyperplasia (BPH).Methods A total of 91 patients undergoing coronary artery angiography (CAG) were selected and divided into two groups according to with or without BPH,56 cases in BPH group,46 cases in control group.The qualitative and quantitative characteristics of 102 lesions area were analyzed by intravascular ultrosound (IVUS),including external elastic membrane-cross-sectional area (EEM-CSA),minimal lumen area (MLA),plaques area (PA),plaques burden (PB),reference external elastic membrane-cross-sectional area (REEM-CSA),reference minimal lumen area (RMAL),reference plaques area (RPA) and reference plaques burden (RPB).Results IVUS showed a higher rate of area stenosis than did the CAG [(58.2± 7.1)% vs.(55.9 ± 5.2)%,P<0.01].BPH group had more soft plaques,eccentric plaques,positive remodeling and less calcified than did the control group (P<0.05).The MLA and RMAL of BPH group were smaller than those of control group:MAL [(5.61±0.96) mm2 vs.(6.06±0.75) mm2,P<0.05],RMAL[(9.26±1.05) mm2 vs.(10.02±1.10) mm2,P<0.05]; while the EEM-CSA,PA,PB,RPA,RPB were larger than those of control group:EEM-CSA[(14.51±1.10)mm2 vs.(13.37±1.02)mm2],PA[(8.90±1.24) mm2 vs.(7.31±1.04) mm2],PB[(61.26±6.53)% vs.(54.53±5.69)%],RPA[(4.26±1.15) mm2 vs.(3.73±1.33) mm2],RPB [(31.30±8.37) % vs.(26.81±8.75) %,P<0.05].Conclusions IVUS has a higher value on evaluation of mild to moderate coronary artery stenosis.Evidence of myocardial ischemia in patients with BPH needs further excludeing coronary heart disease.
ABSTRACT
Objective To evaluate the value of glycogen phosphorylase isoenzyme BB (GPBB) in the diagnosis of early acute myocardial infarction (AMI). Methods The plasma levels of GPBB were mea-sured by sandwich ELISA in 115 patients with suspected AMI at admission within 6 hours after onset of chest pain and 55 normal healthy subjects. The plasma concent of cardiac troponin-Ⅰ (cTnI), creatine kinase-MB (CK-MB) and myoglobin (MYO) was assayed at the same time by using corpuscle chemiluminescence. The patients were classified retrospectively into AMI group (n = 45) , unstable angina pectoris (UAP) group (n =40) , stable angina pectoris (SAP) group (n = 13) and non-cardiac chest pain (NCCP) group (n =17).The diagnostic validity was evaluated in terms of sensitivity and specificity. Results The diagnostic sensitivity of GPBB for AMI was 64.29 % within 3 hours and 88.89 % within 6 hours after onset of chest pain,which is significantly higher than that of cTnI (28.57 %, 60.00 %) and CK-MB (21.43 %, 64.44 % ). There was no significant difference in specificity among the four markers. The diagnostic accuracy of GPBB within 3hours and 6 hours (80.77 %, 89.57% ) was significantly higher than that of cTnI (61.54%, 81.74% ),CK-MB (50.00%, 75.65%) and MYO (73.08% ,73.91%). Conclusions GPBB seems to be a sensitive and specific biochemical cardiac marker for AMI in the early stage. Its diagnostic accuracy is higher than that of cTnI, CK-MB, MYO.