Coronary angiographic features and in-hospital outcome of patients with coronary artery disease and rheumatoid arthritis / 中国介入心脏病学杂志

Objective To report the coronary angiographic features and in-hospital outcome in coronary artery disease(CAD) patients with rheumatoid arthritis(RA) who underwent percutaneous coronary intervention(PCI)with stent implantation.Methods The study group comprised 69 consecutive patients with RA who underwent PCI in Beijing Friendship Hospital between January 2009 and June 2017. Medical records were analyzed retrospectively including clinical basic material, coronary angiogram data, and the incidence of major adverse events in hospital.Results Fifty five patients(79.7％) had one or more traditional CAD risk factors. Multivessel disease was present in 73.9％ of the patients, and the average SYNTAX score was(31.6±7.2). Two bare metal stents and 143 drug eluting stents were implanted. 50 cases(72.4％) required implantation of long stents(stent length>30 mm) .There were 25 patients developed major adverse events(36.2％) during hospitalization, including 1 case of cardiac death, 2 cases of stent thrombosis, 5 cases of PCI related MI, 5 cases of heart failure, 5 cases of gastrointestinal bleeding and 10 cases of contrast induced nephropathy(2 cases comorbided acute heart failure).Conclusions Patients with RA and CAD may have severe coronary lesions.PCI in these patients tends to result in an increased rate of major adverse events in-hospital. Hence there is a need of early identification and early prevention in these patients during perioperative period.

Short- and Long-term Outcomes in Patients with Connective Tissue Diseases Undergoing Percutaneous Coronary Intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Coronary artery disease (CAD) is a leading cause of morbidity and mortality in patients with connective tissue diseases (CTDs). Risk factors and clinical characteristics in these patients are not equivalent to those in traditional CAD patients. The objective of this study was to report short- and long-term clinical outcomes in a consecutive series of patients with CTD who underwent percutaneous coronary intervention (PCI) with stent implantation.</p><p><b>METHODS</b>The study group comprised 106 consecutive patients with CTD who underwent PCI in Beijing Friendship Hospital between January 2009 and June 2012. Medical records were analyzed retrospectively including clinical basic material, coronary angiogram data, and the incidence of major adverse cardiac events (MACEs) during the short- and long-term (median 3 years) follow-up.</p><p><b>RESULTS</b>Ninety-two of the patients (86.8%) had one or more traditional CAD risk factors. Multivessel disease was present in more than 2/3 of patients (73.6%). The left anterior descending coronary artery was the most commonly affected vessel (65.1%). Five bare-metal stents and 202 drug-eluting stents were implanted. After a median follow-up period of 36 months, thirteen patients (12.3%) died from cardiac causes, the rate of stent thrombosis was 9.4%, and the rate of target vessel revascularization (TVR) was 14.2%. Multivariate analysis revealed that hypertension (hazard ratio [HR] = 3.07, 95% confidence interval [CI]: 1.30-7.24, P = 0.041), anterior myocardial infarction (HR = 2.77, 95% CI: 1.06-7.03, P = 0.04), longer duration of steroid treatment (HR = 3.60, 95% CI: 1.43-9.08, P = 0.032), and C-reactive protein level >10 mg/L (HR = 3.98, 95% CI: 1.19-12.56, P = 0.036) were independent predictors of MACEs.</p><p><b>CONCLUSIONS</b>Patients with CTD and CAD may have severe coronary lesions. PCI in these patients tends to result in an increased rate of stent thrombosis and TVR during long-term follow-up, which may be influenced by traditional and nontraditional risk factors.</p>

Association between inflammatory mediators and angiographic morphologic features indicating thrombus formation in patients with acute myocardial infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Inflammatory mechanisms had played an important role in the occurrence and prognosis of acute myocardial infarction, inflammatory mediators was associated with adverse outcomes of acute myocardial infarction. This study tested the hypothesis that in the acute phase of myocardial infarction with ST-segment elevation, neutrophil count and high-sensitivity C-reactive protein are predictive of angiographic morphologic features that indicate thrombus formation in the infarct-related artery.</p><p><b>METHODS</b>This retrospective study included 182 consecutive patients with acute myocardial infarction and ST-segment elevation. Patients were assigned to a thrombus-formation group (n = 77) and a non-thrombus-formation group (n = 106). All patients had a Killip's classification <or= 3 and onset < 12 hours prior to presentation. All the cases were going to undergo coronary angiography, including primary percutaneous coronary intervention, simple coronary angiography, or thrombolysis in a coronary artery (or arteries) or coronary artery bypass graft(s). Blood samples for measurement of high-sensitivity C-reactive protein and for routine blood laboratory studies were collected prior to coronary angiography.</p><p><b>RESULTS</b>The levels of high-sensitivity C-reactive protein, total leukocyte counts, neutrophil counts, and neutrophil/ lymphocyte ratios were substantially higher in the thrombus-formation group than in the non-thrombus-formation group patients (for each, P < 0.05). Stepwise Logistic regression analyses identified high-sensitivity C-reactive protein, neutrophil count, and neutrophil/lymphocyte ratio as independent predictors of thrombus formation in the infarct-related artery (for each, P < 0.05).</p><p><b>CONCLUSIONS</b>In patients with acute myocardial infarction, higher neutrophil counts, neutrophil/lymphocyte ratio, and levels of high-sensitivity C-reactive protein are predictors to indicate thrombus formation.</p>

Research on Change of Inflammatory Factors in Obstructive Sleep Apnea Syndrome with Hypertension / 中华高血压杂志

20 beats/ h);⑤ normal control group(n=20):healthy person without OSAS or hypertension.The serum level of IL-6, sCD40L,hsCRP,sICAM-1,VACM-1 are determined by ELISA method.Results The serum level of IL-6, sCD40L,hsCRP,sICAM-1,VCAM-1 in patients of OSAS alone group or HT alone group is higher than that of normal control group;whereas,the serum level of IL-6,sCD40L,hsCRP,sICAM-1,VCAM-1 in patients with hy- pertension co-existed OSAS are furthermore higher than that of OSAS alone group,hypertension alone group(P