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Objective:To investigate the current situation of insomnia in patients with acute coronary syndrome (ACS), and analyze the influencing factors of insomnia in the ACS patients, so as to provide information on the development of new strategies for the treatment of insomnia in ACS patients.Methods:This is a multicenter and prospective observational study. A total of 771 ACS patients who met the criteria were selected from March 2013 to June 2015. The baseline social demographic information, sleep quality questionnaire, general anxiety disorder scale-7(GAD-7),patient health questionnaire-9(PHQ-9), short-form 12 health survey questionnaire(SF-12), and enhancing recovery in coronary heart disease patients social inventory(ESSI) were completed within 7 days after admission. Logistic regression analyses were used to analyze the influencing factors of insomnia in ACS patients.Results:A total of 741 subjects with valid questionnaires were collected, including 510 males (68.8%) and 231 females (31.2%). Among them, 487 (65.7%) subjects had at least one insomnia symptom: 308 (41.6%) subjects had difficulty in falling asleep, 369 (49.8%) subjects were easy to wake at night, 116 (15.7%) subjects woke up earlier than they expected, 74 (10.0%) subjects experienced both woke up earlier and difficulty in falling asleep, and 53 (7.2%) subjects woke up earlier, woke up at night and had difficulty in falling asleep at the same time. Logistic regression analyses showed that before admission physical activity ( OR =0.636, 95% CI 0.411-0.984), depression ( OR=1.908, 95% CI 1.101-3.305) and low social support ( OR=0.278, 95% CI 1.198-3.301) were independent factors of insomnia in ACS patients. Conclusions:Nearly 2/3 ACS patients have symptoms of insomnia. Difficulty in falling asleep and easy to wake up at night are the most common manifestations. Physical activity, depression and social support independently are associated with insomnia.
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Objective: To investigate the predictive value of an early inflammatory response factor, Rho kinase activity for left ventricle remodeling (LVR) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: A total of 120 acute STEMI patients treated in our hospital from 2010-10 to 2013-06 were studied, all patients were ifrst time received primary percutaneous coronary intervention (PCI) with stent implantation. Rho kinase activity and B-type natriuretic peptide (BNP) were measured before PCI, echocardiography was conducted at 24 hours and 12 months after STEMI respectively to clarify LVR diagnosis. The patients were divided into 2 groups as LVR group, n=97 and Non-LVR group, n=23, the above indexes were compared between 2 groups. Results: The level of Rho kinase was higher in LVR group than that in Non-LVR group, P Conclusion: High Rho kinase activity could predict LVR in acute STEMI patients with primary PCI and stent implantation.
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Objective To evaluate the clinical effects of large dosage capoten(captopril)combined with irbesartan in the treatment of congestive heart failure(CHF).Methods One hundreds thirty nine patients of CHF were occasionally divided into two groups:large dosage capoten group(n=61)and large dosage capoten+irbesartan group (n=78).240 days later,the changes of cardiothoracic ratio(CTR),left ventricular end diastolic diameter(LEVD),left ventricular end contract surface(LVES),left ventricular eiection fraction(LVEF),6-minute walking test (6MWT),admission frequency,and mortality rate were observed before and after therapy.Results Large dosage capoten+irbesartan group can significantly reduce the admission frequency of CHF patients(P＜0.01),while large dosage capoten group was better than large dosage capoten+irbesartan group in 6MWT,LEVD,LVES,and LVEF (P＜0.05).There was no significant difference in CTR and mortality rate between two groups(P＞0.05)Conclusion Capoten combined with irbesartan have better clinical effects than single capoten in the treatment of CHF and it was worthy of extending in clinic.
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Objective To explore the relationship of the presence and severity of anxiety and depression with the increased inflammatory activity,as marked by the serum levels of high sensitivity C reactive protein(hs-CRP)after acute coronary syndrome(ACS).Methods Serum hs-CRP levels were measured in 647 ACS patients within 36 hours after onset of event.Depression and anxiety were evaluated by self-reporting standardized questionnaire,using a validated Chinese version of Hospital Anxiety and Depression Scale(HADS)(14 items)within 7 days.Results In ACS patients,serum levels of hs-CRP(mg/L)were lower in those with anxiety than those in control group[(10.43?3.55)mg/L vs(13.19?4.90)mg/L,P0.05].Conclusion Presence and severity of depression is associated with increased activity of inflammation in patients with ACS;however,anxiety does not have such an association with inflammation in patients with ACS.
