简介：Tostudytherelationshipbetweenmyeloperoxidase(MPO)-463G/Apolymorphismsandsusceptibilitytocoronaryarterydisease(CAD)inHanpeopleofnorthAnhuiprovince.MethodsThecasegroupconsistedof79patientswhohadallangiographicallyprovenCADwereretrospectivelystudied.Usedpolymerasechainreaction-restrictionfragmentlengthpolymorphism(PCR-RFLP)methodstodecidethegenotypeofallthepatients.ResultsThefrequencyofAAhomozygotictypeinHanpeopleofAnhuiprovincewas1.4%.TheriskofCADforpersoncarryingatleastoneAallelegenotype(GAandAA)was0.37timesofGGgenotype.TheseverityofcoronaryarterystenosisinCADpatientscarryingatleastoneAallelegenotypewas0.197timesofGGgenotype(P<0.05).ConclusionsThefrequencyofAAhomozygotictypeandMPO-463G/ApolymorphisminHanpeopleofAnhuiprovinceinfluencedtheriskofCAD.AallelehadprotectivefunctioninCAD.

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简介：Repeatcoronaryrevascularizations(RCR)arecommoninpatientsunderwentpercutaneouscoronaryintervention.ThereisnoavailablepredictionmodelforRCRatpresent.Theassociationbetweenparaoxonas-1(PON1)andthedevelopment,progression,andprognosisofcoronaryarterydiseaseisunderhotresearch.Therela-tionshipofserumPON1activitylevelandRCRhasnotbeenreported.ThisresearchaimedtodetectthedifferenceofserumPON1activitylevelsbetweenRCRandsinglecoronaryrevascularization(SCR),hencetoilluminatethevalueofPON1inpredictingRCR.MethodsSerumPON1activitylevelsof200patientswhohadachievedcompleterevascu-larizationsinfirstpercutaneouscoronaryintervention(PCI)weredeterminedbycolorimetricmethod.Allpatientsre-ceivedone-yearfollow-up.Coronaryangiographieswereperformedat6thmonth.Patientswhoneedmorerevasculariza-tionprocedureduringfollow-upwereenrolledinRCRgroup;thosewhodidnotneedmorerevascularizationprocedurewereenrolledinSCRgroup.Onehundredpatientswithnormalcoronaryangiographyduringthesameperiodweresetupasnon-coronaryheartdiseasecontrolgroup(NCC).ResultsSixtytwopatientswereenrolledinRCRgroup(28within-stentrestenosis,34withlesionprogressioninothercoronarysegments).SerumPON1activitylevelsinRCRgroup,SCRgroupandNCCgroupwere109.2±98.6μkat/L,132.8±79.4μkat/Land156.4±82.8μkat/L,respective-ly.Statisticdifferenceswerefoundamongthreegroups(P<0.05).ConclusionsSerumPON1activitylevelsarelowerinpatientswhoneedrepeatcoronaryrevascularizationsthaninpatientsneedsinglepercutaneouscoronaryinter-ventionorwithoutcoronaryheartdisease.AlowerserumPON1activityleveliscloselyassociatedtorepeatcoronaryre-vascularization.

简介：ObjectivesToinvestthesuccessprocedure,immediateoutcomeafterprocedure,therateofmainadversecardiaceventsafterprocedureandrestenosisafterstentplacementinsmallcoronaryvessels.Methods290patientswithselectedoremergencystentimplantationinsmallvesselsfromApril,1997toMarch,2002.Total299vessels,304lesionsand316stentswerestatisted.Thesuccesssrateofprocedure,immediateoutcomeafterprocedure,therateofmainadversecardiaceventsafterprocedureandrestenosisafterstentplacementinsmallcoronaryvesselswereassessed.Thepatientswerefollowedup1monthto4years.Re-catheterangiographyweredonein122/290patients.ResultsThenarrowrateoflesiondroppedfrom89%±12%beforeprocedureto5%±5%afterprocedure(diameter).202patientswerefollowedup1month(69.7%).197/202casesweresurvival.5/202casesdiedin3hrsto7days.2/5casesdiedofpersistenthypotensionafterprocedure.1/5casediedofacuteleftheartfailure.2/5casesdiedofsuddendeath.180caseswerefollowedup5monthsto4years.Thenon-eventsurvival(NES)ratewas73.3%(132/180).There-angiographyweredonein122cases.Restenosishappenedin39cases(30.3%).37patientsrepeatedPCI.2patientswenttoCABG.2casesgotanginarecurrenceandwereprovedsecondtimerestenosisbyre-angiography.ThethirdtimePCIwasdonein1patient.TheotherpatientswenttoCABG.1casediedofchronicheartfailureafter2years.1casesufferedacutemyocardialinfarctiononarterystentimplanted.ConclusionsTherearehighsuccessrateofprocedureandperfectimmediateoutcomeinstentplacementinsmallvessels.Mainadversecardiaceventsdidnotincreased.Non-eventsurvialwassatisfiedinlongtermfollow-up.Restenosisratewasshowedslightlyhigherthantheoneofmainvessels.

简介：BackgroundThrombocytopeniaisacommoncomplicationofIABP.Untilnow,thereisnounifiedconclusionsabouttheincidence,characteristics,riskfactorsandtheprognosisofIABPrelatedthrombocytopenia.MethodsInthisstudy,thedataofpatientswithACSundergoingPCIandIABPwereretrospectivelyanalyzed.Allenrolledpatientsweredividedintothrombocytopeniagroupandnon-thrombocytopeniagroupaccordingtotheoccurrenceofthrombocytopeniaafterinsertionofIABP.Thebaselinedataofthetwogroupswerecompared,andthepossibleriskfactorsofthrombocytopeniaandtheirimpactonprognosiswereanalyzedbychi-squaretestandlogisticregressionanalysis.ResultsSixty-twopatientswereenrolledinthisstudy.TherateofIABPassociatedthrombocytopeniawas25.8%(16/62)ofallpatients.OlderagewasanindependentriskfactorofIABPassociatedthrombocytopenia(OR:3.625;95%confidenceinterval:1.016-12.935;P=0.047).TheincidenceofTIMIbleedingeventswashigherinthrombocytopeniagroup[75.0%(12/16)vs.43.5%(20/46),P=0.042].Therateofin-hospitaldeathwassimilarbetweenthetwogroups[18.8%(3/16)vs.17.4%(8/46),P=1.0].ConclusionIABPassociatedthrombocytopeniaoccursin25.8%ofpatientswithACSundergoingPCIandcorrelateswithincreasedTIMIbleedingevents.OlderagemaypredictIABPassociatedthrombocytopenia.

简介：Percutaneouscoronaryintervention(PCI)improvessymptomsandprognosisinischemia-inducing,functionallysignificant,coronarylesions.Useoffractionalflowreserveallowsphysicianstoinvestigatetheischemia-inducingpotentialofaspecificlesionandcanbeusedtoguidecoronaryrevascularization,especiallyinmultivesselcoronaryarterydisease.Fractionalflowreserve-guidedPCIhasbeenextensivelyinvestigated.Resultsshowthatdeferralofstentinginnon-significantlesionsissafe,whereasdeferralofstentinginfunctionallysignificantlesionsworsensoutcome.FFR-guidedPCIimprovesoutcomeinmultivesseldiseaseoverangiography-guidedPCI.Untilrecently,therewaslittleknownaboutthelong-termoutcomeofFFR-guidedrevascularizationanditsvalidityinacutecoronarysyndromes.Thisreviewaimstoaddressthenewevidenceregardinglong-termappropriatenessofFFR-guidedPCI,theneedforhyperemiatoevaluatefunctionalseverity,andtheuseofFFRinacutecoronarysyndromes.

简介：BackgroundAfterpercutaneouscoronaryintervention(PCI),somepatientsmaysufferfromrestenosisandstentthrombosis.Manystudiessuggestthatendothelialprogenitorcell(EPC)hasanimportantroleinpreventingrestenosisandstentthrombosis.AnovelstentwhichcanattractEPChasbeendesignedtoprovideabetteroutcomefortheseproblems.MethodThedataofthepresentreviewwasobtainedbysearchingPUBMEDandotherdatabases(1994-2011)usingthekeytermsof'endothelialprogenitorcell','reendothelialization','restenosis','stentthrombosis',and'percutaneouscoronaryintervention'.ResultRapidreendothelializationisessentialinpreventingrestenosisandstentthrombosis.EPCcandifferentiateintoendothelialcellandacceleratethereendothelialization.Afternumerouspreclinicalandclinicalresearches,thecorrelationbetweencirculatingEPCstorestenosisstillremainspoorlyunderstood.However,manystudieshaveshowntheimportantroleofEPCindiminishingtheriskofthrombosisfollowingstentimplantation.Somepharmacologicalagentshavebeenreportedcanincreasethenumberand/orfunctionsofEPC.Recently,CD34+antibodycoatedstenthasbeendevelopedtoattractEPCtothehealingendothelium,andhasshowedfavorableresults.ConclusionEPChasimportantroleinrapidreendothelializationaftervascularinjury.EPCcanpreventstentthrombosisafterPCI,howevertheeffectsofEPCinpreventingrestenosisneedfurtherinvestigations.ThecapturingCD34+stentissafeandsignificantlydecreasesstentthrombosis.

简介：ObjectivesTodetectionofchlamydiapneumoniae(Cpn)DNAinthecirculatingmononuclearcellfractionsofcoronaryheartdiseaseandtoinvestigatetheassociationbetweeninfectionwithchlamydiapneumoniaeandcoronaryheartdisease(CHD)andprospectivelywhetherblood-basednestedpolymerasechainreaction(nPCR)isusefulinidentifyingCpninfection.MethodsTheperipheralbloodmononuclearcell(PBMC)CpnDNAwasexaminedusingnPCRtechniqueandconfirmedbyelectrophoresisin150patientswithCHD.Select55patientswithclinicalsuspectedCHDbutangiographyresultarenormalascontrolgroup(CG).Thenweconductedaprospective,randomized,double-blind,placebo-controlledstudyof6monthsofazithromycinandplacebotreatmentinCHDgroup.PatientswithCpnDNApositivewerethenrandomizedtoreceiveazithromycinorplacebo.Aftertreatmentbloodsamplewerecollectedforrepeatedmeasurement.ResultsChlamydiapneumoniaeDNAwasdetectedin49(32.7%)of150personswithCHDandin1(1.8%)of55personswithcontrolgroup,oddsratio26.2,95%confidenceinterva13.52-194.98.ThepositivityratesofnPCRinCHDgroupswerehigherthanthoseincontrolgroup.16cases(29.1%)inlatentcoronaryheartdiseases(LCHD)group,19cases(39.6%)inunstableangina(UAP)group,and14cases(29.9%)inacutemyocardialinfarction(AMI)groupwereCpnpositivebynPCR.TherewerenosignificantdifferenceamonginAMIUAPandLCHDgroup.ThereweresignificiantdifferenceinCpnDNAnegativeratesaftertheazithromycinandtheplacebotreatment.ConclusionsChlamydiapneumoniaeispresentinPBMCofasignificantproportionofpersonswithCHD.Thepotentialroleofchlamydiapneumoniaeincoronaryatherosclerosismaythereforebemorerelatedtoaccelerationofdiseaseorsystemiceffectsbypersistentinfectionthantosuddeninitiationofprogressivecoronaryarterydiseasebyacuteinfection.ThedetectionofCpnDNAinPBMCwithnPCRmaybeofgreatvalueforidentifyingCpncarriersandfo

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简介：AbstractBackground:The development of the technique has improved the success rate of percutaneous coronary intervention (PCI) for instent chronic total occlusion (IS-CTO). However, long-term outcomes remain unclear. The present study sought to investigate long-term outcomes of PCI for IS-CTO.Methods:A total of 474 IS-CTO patients were enrolled at two cardiac centers from 2015 to 2018 retrospectively. These patients were allocated into either successful or failed IS-CTO PCI groups. The primary endpoint (major adverse cardiac events [MACE]) consisted of recurrent angina pectoris (RAP), target-vessel myocardial infarction (MI), heart failure, cardiac death, or ischemia-driven target-vessel revascularization (TVR) at follow-up. Multivariable Cox regression analysis was used to investigate the association between treatment appropriateness and clinical outcomes.Results:A total of 367 patients were successfully treated with IS-CTO PCI while 107 patients had failed recanalization. After a median follow-up of 30 months (interquartile range: 17-42 months), no significant difference was observed between the two groups for the following parameters: cardiac death (successful PCI vs. failed PCI: 0.9% vs. 2.7%; adjusted hazard ratio [HR]: 1.442; 95% confidence interval [CI]: 0.21-9.887; P = 0.709), RAP (successful PCI vs. failed PCI: 40.8% vs. 40.0%; adjusted HR: 1.025; 95% CI: 0.683-1.538; P = 0.905), heart failure (successful PCI vs. failed PCI: 6.1% vs. 2.7%; adjusted HR: 0.281; 95% CI: 0.065-1.206; P = 0.088), target-vessel related MI (successful PCI vs. failed PCI: 1.5% vs. 2.7%; adjusted HR: 1.150; 95% CI: 0.221-5.995; P = 0.868), MACE (successful PCI vs. failed PCI: 44.2% vs. 45.3%; adjusted HR: 1.052; 95% CI: 0.717-1.543; P = 0.797). More patients were free of angina in the successful IS-CTO PCI group compared with failed PCI in the first (80.4% vs. 60%, P < 0.01) and second years (73.3% vs. 60.0%, P = 0.02) following up. Successful IS-CTO PCI had a lower incidence of MACE in the first and second years (20.2% vs. 40.0%, P < 0.01; 27.9% vs. 41.3%, P = 0.023) compared with failed PCI. After a median follow-up of 30 months, the reocclusion rate was 28.5% and TVR was 26.1% in the successful IS-CTO PCI group. Receiving >18 months of dual antiplatelet therapy (DAPT) was an independent predictor of decreased risk of TVR (HR: 2.682; 95% CI: 1.295-5.578; P = 0.008) or MACE (without TVR) (HR: 1.898; 95% CI: 1.036-3.479; P = 0.038) in successful IS-CTO PCI.Conclusions:After a median follow-up of 30 months, the successful IS-CTO PCI group had MACE similar to that of the failed PCI group. However, the successful IS-CTO PCI group had improved angina symptoms and were free from requiring coronary artery bypass grafting in the first or second years. To decrease MACE, DAPT was found to be essential and recommended for at least 18 months for IS-CTO PCI.

简介：ObjectivesToevaluatetheeffectofdifferentstylesofcoronaryheartdisease(CHD),differentregionsofacutemyocardialinfarction(AMI),itsriskfactorsandbranchesofcoronarystenosisonleftventricularremodelinganddysfunctionbyapplyingechocardiography.Methods251patientswithCHDand96patientswithoutCHD(NoCHD)wereverifiedbyselectivecoronaryangiography.CHDpatientsweredividedintostableanginapectoris(SAP)26,unstableanginapectoris(UAP)53,acutemyocardialinfarction(AMI)140andoldmyocardialinfarction(OMI)30basedonclinicalsituation,cTnT,cardiacenzymeandEGG.AMIpatientswerefurtherdividedintosubgroupsincludingacuteanteriormyocardialinfarct(Aa,n=53),acuteinferiormyocardialinfarction(Ai,n,=54)andAa+Ai(n=33)basedonECG.Cardiacparameters:end-diastolicinterventricularseptumthickness(IVSd),end-diastolicleftventricularinternaldiameter(LVd),leftventricularmass(LM),end-diastolicleftventricularvolume(EDV),end-systolicleftventricularvolume(ESV)andleftventricularejectionfraction(LVEF)weremeasuredbyACUSON128XP/10echocardiography.MultipleslinearregressionanalyseswereperformedtoteststatisticalassociationsbetweenLVEFandtheinvolvedbranchesofcoronarystenosis,bloodpressure,lipids,glucoseandetcafteronsetofmyocardialinfarction.ResultsEDVandESVwereincreasedandLVEFdecreasedonpatientswithAMI,OMIandUAP(P<0.05-0.0001).LMwasmainlyincreasedinpatientswithOMI(P<0.01)andLVdwasmainlyenlargedinpatientswithAMI.EFwassignificantlydecreasedandEDV,ESV,LMandLVdwereremarkablyincreasedinAMIpatientswithAaandAa+Ai.WiththemultiplelinearregressionanalysesbySPSSsoftware,wefoundthatLVEFwasnegativelycorrelatedtotheinvolvedbranchesofcoronarystenosisaswellastosystolicbloodpressureafteronsetofmyocardialinfarctionwhiletherewasnosignificantcorrelationbetweenLVEFandotherfactors.LVEFwassignificantlydecreased,and

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简介：Inrecentyears,Percutaneouscoronaryintervention(PCI)asaneffectivetreatmentforcoronaryheartdiseasehasbeenwidelycarriedoutinChina.However,peopleisstillconfrontedwiththeproblemthattheincidenceofin-stentrestenosis(ISR)afterPCI.Someriskfactorsofcoronaryheartdiseasehavebeenobviouslyknown,butthein-dependentpredictorfactorsfortheISRhasnotbeenclear.ClarifyingriskfactorsforISRtoestablishinterferingmeas-uresmaybeanewdirectionforPCItreatmentinthefuture.Atpresent,ithasbeenreportedthataldosterone(ALD)maybeinvolvedinISR.InordertofurtherinvestigatetherelationshipbetweentheserumALDlevelsandISR,ourre-searchwastodeterminetheALDandotherserummarkerstoexploretheimpactfactorsofISR.MethodsWemeas-uredserumALD,highsensitivityC-reactiveprotein(hs-CRP),adiponectin(ADP)andotherindicatorsin258pa-tientswithcoronarystenting,andmaderoutinefollow-upfor6-9monthstoperformcoronaryangiography.Accordingtotheresultsofcoronaryangiography,allpatientsweredividedintorestenosisgroupandnon-restenosisgroup.Wean-alyzedtherelationshipbetweenALD,otherindicatorsandISRtoexplorewhetherserumALDwasanindependentriskfactorISR.ResultsSerumALDlevelsweresignificantlyhigherinrestenosisgroupthannon-restenosisgroup.Logis-ticregressionanalysisshowedthatdiabetes,ALD,hs-CRPandcomplexlesionswerealsoindependentriskfactorsforISR(P<0.05),whiletheADPwasasaprotectivefactorforISR(P<0.05).ConclusionsALDisoneofinde-pendentriskfactorsforISRafterundergoingcoronarystentimplantationinpatients.Ithasthepossibilityofbecomingonenewmethodinthismedicalfield.

简介：AbstractBackground:Diabetes mellitus (DM) is considered a cardiovascular risk factor. The aim of this study was to analyze the prevalence and volume of coronary artery plaque in patients with diabetes mellitus (DM) vs. those without DM.Methods:This study recruited consecutive patients who underwent coronary computed tomography (CT) angiography (CCTA) between October 2016 and November 2017. Personal information including conventional cardiovascular risk factors was collected. Plaque phenotypes were automatically calculated for volume of different component. The volume of different plaque was compared between DM patients and those without DM.Results:Among 6381 patients, 931 (14.59%) were diagnosed with DM. The prevalence of plaque in DM subjects was higher compared with nondiabetic group significantly (48.34% vs. 33.01%, χ2 = 81.84, P < 0.001). DM was a significant risk factor for the prevalence of plaque in a multivariate model (odds ratio [OR] = 1.465, 95% CI: 1.258-1.706, P < 0.001). The volume of total plaque and any plaque subtypes in the DM subjects was greater than those in nondiabetic patients significantly (P < 0.001).Conclusion:The coronary artery atherosclerotic plaques were significantly higher in diabetic patients than those in non-diabetic patients.

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简介：ObjectivesToelucidatethepotentialroleofcytokinesinthepathogenesisofcoronaryheartdisease(CHD).MethodsTNF-αandIFN-γactivity,IL-8levelsofplasmaandsupernatantsweremeasuredin62patientswithCHDand30healthcontrolsbymethodsofdirectcytotoxicityassay,cytopathiceffectinhibitiontestandELISArespectively.ResultsBothTNF-αactivityandIL-8levelsofplasmainCHDpatientswerehigherandIFN-γactivityofsupernatantsinCHDpatientswerelowerthanthoseofhealthycontrols(P＜0.001),TherehavesignificantdifferencesbetweenhealthycontrolsandthesubgroupsofCHD(P＜0.01).IL-8levelsofplasmaincreasedwiththeadvancingofthediseaseandtherehaveobviousdifferencesamongsubgroupsoftheillness(P＜0.05).TNF-αactivityofplasmainstableanginapectoris(SAP)subgroupwaslowerthanthoseofunstableanginapectoris(UAP)andacutemyocardialinfarction(AMI)subgroups,thedifferencesbetweenSAPandUAPorAMIweresignificant(P＜0.05),ButtherehavenosignificantdifferencesbetweenUAPandAMI(P＞0.05).However,IFN-γactivityofsupernatantsshowednodifferenceamonganysubgroups.ConclusionstherehavecloserelationsbetweenTNF-α,IFN-γ,IL-8andCHD.

简介：大多数商品化的冠的stents用316L做的由于它性质的好联合，并且当前，某新stents用由于它的更高机械的性质的基于钴的合金做的不锈钢。然而，在这些材料的镍或钴元素的高数量的存在，被知道触发有毒、过敏的回答，引起了许多担心。没有镍的奥氏体的不锈钢被开发了以便解决这些问题。在这份报纸，基于新Fe-Cr-Mn-Mo-N的开发打高氮没有镍的奥氏体的不锈钢，性质象机械性质那样，在汉克的解决方案，并且在包括运动clotting时间和血小板粘附的vitro血相容性的腐蚀电阻，与上述二常规材料，316L不锈钢和Co-28Cr-6Mo合金相比被调查。结果证明新高氮钢钢和Co-28Cr-6Mo合金，和罐头是的316L比那些拥有了机械性质，腐蚀抵抗和血相容性的更好的联合为冠的stents的制造的有希望的其他的材料。

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简介：BackgroundPreviousstudieshaveimplicatedastronglinkbetweencirculatingplasmaresistinandcoronaryarterydisease(CAD).Theaimofthisstudywastoinvestigatewhetherresistinelevationpredictsworseoutcomeofstent-placementinacutecoronarysyndrome(ACS)patients.MethodsTotally126ACSparticipantswhowereeligibleforstent-placementwereenrolledfor2years'follow-upbymonitoringclinicalendpointsoccurringviaoutpatientvisitsor/andtelephonecall.Baselinecharacteristicswerecollected.Allparticipantsweredividedintolowresistingroup(<3.464μg/mL)andhighresistingroup(>3.464μg/mL).Clinicalendpointsintermsofmajoradversecardiovascularevents(MACE),cardiovasculardeath,non-fatalmyocardialinfarction,ischemicstroke,andcoronaryrevascularization(CR)werecompared.ResultsPatientswithstenosisinthreevesselspresentedmorefrequentlyinhighresistingroupthaninlowresistingroup(35.6%vs.48.3%,P=0.001).IncidencesofMACEandCRweresignificantlyhigherinhighresistingroupthanthoseinlowresistingroup(31.6%vs.18.8%,P=0.018);15%vs.7.58%,P=0.006).ConclusionsInpatientswithbaselineresistinelevation,theincidenceofMACEissignificantlyincreasedafterstent-placement.

简介：AbstractObjective:To identify risk factors of saphenous vein graft (SVG) failure and to investigate the utility of anatomical SYNTAX score (SS) and SYNTAX score II (SS-II) in predicting SVG failure.Methods:A total of 598 patients who underwent angiography for clinical reasons after coronary artery bypass grafting (CABG) were included. Baseline data and factors related to SVG failure were analyzed at the patient and graft levels. Patients were divided in tertiles by anatomical SS and in three groups by SS-II revascularization recommendation, and SVG patency was analyzed across these groups.Results:Patency rates were similar in all SS-stratified and SS-II recommendation groups within 1, 5, and 10 years after CABG. At the patient level, fasting blood glucose (FBG) level <7.0 mmol/L was less common in SVG failure (68.0% vs. 76.2%). At the graft level, patients with SVG failure tended to have angiography later (4.0 years vs. 3.0 years), poorer FBG control (FBG <7.0 mmol/L: 68.2% vs. 74.7%), and more grafts anastomosed to the right coronary system (59.2% vs. 47.4%). Longer time interval after CABG was related to SVG failure both at the patient and graft levels, and odds ratio (OR)/P values (OR/P) were 1.282/0.029 and 1.384/0.016, respectively. Using independent graft and grafting to the right artery system as risk factors at the graft level, OR/Ps were 3.094/0.000 and 2.524/0.000, respectively.Conclusions:Longer time interval after CABG, independent grafts, and grafting to the right artery system are associated with SVG failure. Anatomical SS or SS-II may not be reasonable tools for predicting SVG failure.