ABSTRACT
Objective To compare the clinical efficacy and safety with statin and ezetimibe in the treat-ment of ACS after PCI. Methods 126 patients with acute coronary syndrome(ACS)who underwent percutaneous coronary intervention(PCI )were divided into three groups according to the lipid-lowering strategy. group A:mod-erate-intensity statin group(n = 47),group B:Ezetimibe combined with moderate-intensity statin(n = 38), group C:Fortified statin(n = 41). The levels of serum lipids,liver enzymes,creatinine,creatine kinase(CK), and the compliance ratio of lipids were compared between the three groups at 1 month and 6 months after PCI re-spectively. All patients were followed up for 12 months,then reviewing coronary angiography and comparing MACE incidents within 12 months. Results The levels of cholesterol in group A,group B and group C decreased signifi-cantly(P < 0.05)at one month after PCI,the percentage of decrease of TC in three groups was 18.95%,35.61%and 19.84% and 24.89%,and LDL-C was 39.56%,23.99%,respectively. The percentage of TC and LDL-C in group B were significantly lower than those in other two groups(all P < 0.05). One months after PCI,the compli-ance rate of LDL-C in group B(65.8%)was higher than that in A group(34.0%)and C group(31.7%),P <0.05. Six months after PCI,the compliance rate of LDL-C in group B( 91.3% )was still significantly higher than that in group A(79.4%)and group C(84.2%),but P > 0.05. The incidence of MACE in group B was significant-ly lower than that in group A and C(P < 0.05)at 12 months after PCI,while the incidence of side effects in group C was significantly higher than that in group B and group A(P < 0.05). The incidence of neovascular steno-sis in group B was lower than that in group A and C(all P < 0.05). There was no significant difference in the intra-ventricular restenosis among the three groups(all P > 0.05). Conclusions Ezetimibe-statin combination therapy reduced TC and LDL-C levels more significantly than statin alone(including moderate-intensity statin therapy and strengthen statin therapy),and the compliance rate of LDL-C at 1 month after PCI was significantly higher than that of statin alone. The incidence of MACE was lower in combination group than in statin group at 12 months after operation,and the side effects were less. Above all,the combination of statin and ezetimibe may be the secondary prevention for CHD in patients with acute coronary syndrome after PCI.
ABSTRACT
Objective To evaluate the significance of contrast medium (CM) volume and estimated glomerular filtration rate (CM/eGFR) in predicting contrast-induced nephropathy (CIN) after PCI. Methods A total of 307 patients after PCI were enrolled from Nanfang Hospital from May 2014 to October 2015. The patients were divided into the CIN group(n = 29) and the non-CIN group(n = 278) according to whether CIN within 72 hours after PCI. The baseline renal function was assessed by the sCr and CyC, respectively. Results Twenty-nine patients (9.4%, 29/307) developed CIN. There were significant differences in Age, CM、NTpro-BNP、IABP、 Periprocedural Hypotension、Preprocedural sCr/CyC between two groups (P < 0.05, respectively). The result of multivariate logistic regression analysis showed that Age, Cardiac function ≥Ⅲ level, IABP, use CCB, CM/eGFRMDRD, CM/eGFRCyC were independent risk predictors for CIN, respectively. Receiver Operating Characteristic (ROC) curve analysis showed that the area under the curve of CM/eGFRMDRD(AUC = 0.838) was superior to CM/eGFRCyC (AUC = 0.805) without significant difference. The sensitivity and specificity were 79.3%and 76.3%(Cut-off Point = 2.094), respectively. Conclusion Both the CM/eGFRMDRD and CM/eGFRCyC may be good methods to determine maximum CM before PCI and to predict CIN after PCI currently, without significant differences between these two predictors.
ABSTRACT
Objective To investigate the relationship between stent thrombosis and obstructive sleep apnea-hypopnea syndrome (OSAHS) in patients after coronary artery stent implantation (CASI). Methods One hundred and seventeen patients were rolled after CASI, of which 29 suffering from OSAHS were enrolled into the research group, 88 patients without OSAHS were enrolled into the control group. The incidence rate of stent thrombosis between the above two groups was analyzed. Results Three patients suffered stent thrombosis in the research group, with the incidence rate of 10.3%,which was significantly higher than that in the control group, with the incidence rate of 1.10%(P = 0.047). Conclusions After CASI, patients with OSAHS had higher risk of stent thrombosis compared with patients without OSAHS. OSHAS should be considered as a risk factor for stent thrombosis.